Oklahoma Licensed Case Manager

A company is looking for a Case Manager - Utilization Review.

Key Responsibilities

Conduct timely medical necessity reviews using medical coverage guideline criteria

Present cases that do not meet clinical criteria to the Medical Director

Communicate with payers to ensure timely clinical review submissions

Required Qualifications, Training, and Education

Graduate from an accredited school of nursing required; Bachelor of Science in Nursing preferred

Three years of clinical nursing experience in an acute care facility

Current RN License issued by the Oklahoma State Board of Nursing or a multistate Compact RN License

Experience with utilization review or case management preferred

Case management certification preferred