Job Posting Title
Nurse Care Manager
Agency
807 HEALTH CARE AUTHORITY
Supervisory Organization
Care Coordination Services
Job Posting End Date
Refer to the date listed at the top of this posting, if available. Continuous if date is blank.
Note: Applications will be accepted until 11:59 PM on the day prior to the posting end date above.
Estimated Appointment End Date (Continuous if Blank)
Full/Part-Time
Full time
Job Type
Regular
Compensation
$65,607.00/ year
Why You’ll Love Working Here
At the Oklahoma Health Care Authority (OHCA), your work matters. Every day, our team helps ensure Oklahomans have access to better health and better care. Guided by our core values, Passion for Purpose, Trust & Transparency, Empowerment & Accountability, Best-in-Class, Outcome-Driven, and Servant Leadership, we foster a workplace where people feel supported, respected, and empowered to make an impact. Learn more about OHCA.
Let’s Talk Benefits
We know your great work deserves great support. Here’s a snapshot of what we offer for all eligible employees.
Generous state-paid benefit allowance to offset insurance premiums.
A wide selection of insurance plans with no pre-existing condition exclusions.
Flexible Spending Accounts for health care and dependent care.
Retirement Savings Plan with employer contributions.
11 paid holidays annually.
15 days of vacation and 15 days of sick leave in the first year.
Longevity Bonus recognizing years of public service.
Public Service Loan Forgiveness eligibility and tuition reimbursement.
Wellness benefits, including an on-site gym and fitness center discounts.
Location: 4345 N Lincoln Blvd, Oklahoma City, OK 73105
Salary: $65,607.00/ year
Work Schedule: Monday – Friday
Primary Hours: 8:00 a.m. – 5:00 p.m.
The Oklahoma Health Care Authority (OHCA)works to ensure Oklahomans have access to better health and better care.The agency’s core values include passion for purpose, trust and transparency,empowermentand accountability, best in class and outcome-driven, and servant leadership.As part of the interview process, candidates maybe requiredto attend an in-person interview at our Oklahoma City office.
The Nurse Care Manager ensures that medically complex and special healthcare needs ofSoonerCaremembers are effectively managed by coordinating access to medical care, community resources, and social services. This role involves conducting clinical reviews,facilitatingcare management activities, and collaborating with intra- and inter-agency personnel to ensure program adherence to state and federal guidelines. Additionally, the Nurse Care Manager supports the agency’s mission by providing leadership in resolving member issues, contributing to case management decisions, and advocating for the needs of vulnerable populations while ensuring compliance with OHCA policies and program requirements.
Coordinate andfacilitateaccess to medical care for medically complex/special health care needs membersidentifiedthrough various referral sources, including self-referrals, provider referrals, and other state agency referrals. Facilitate access to community resources and social service agencies within the parameters of theSoonerCareprogram
Conduct clinical reviews and document Care Management activitiesutilizingthe clinical case management system and other available tools. Complete level of care determinations and assessments foridentifiedpopulations using standardized tools and processes. Prepare cost-effectiveness statements, reports, and other necessary documentation. Evaluates the quality of services provided by licensed and non-licensed health care members.
Collaborate with intra-agency and inter-agency personnelregardingpolicy and program issues related to Care Management. Participate in case staffing meetings and collaborate with other agency staff to ensure coordination of efforts. Provide testimony as requested for adjudication of administrative appeals.
Interface verbally and in writing with members, families, and providers to resolve issues. Act as aSoonerCareCare Management resource, answering questions forOHCA personnel related to the complex special needs of identified members.
Work with internal and external QA processes tomonitorprogram adherence to state and federal guidelines and contracts. Represent OHCASoonerCarein public forums involving various stakeholder groups, informational seminars, and training sessions as assigned.
Evaluate appropriateness for healthcare services foridentifiedclients and make recommendations for care plans based on established guidelines for the client's diagnosed condition.
Other duties as assigned.
Qualifications:To perform this job successfully, an individual must be able to perform eachessential duty satisfactorily. The requirements listed below are representative of the knowledge,skill, and/or abilityrequired
The Nurse Care Manager requires in-depth knowledge of healthcare policies, clinical case management, and community resource coordination, along with the ability to communicate effectively with members, providers, and agencies. Strong problem-solving skills and strategic thinking are necessary for navigating complex healthcare systems, ensuring compliance, and advocating for members with special healthcare needs. The Korn Ferry competencies that best align with this role include Ensures Accountability(demonstratingownership for program adherence and compliance) and Collaborates(working effectively with diverse internal and external stakeholders to provide comprehensive care management).
**To be considered for this position your application must include a resume/CV with complete work and education history.**
Possession of a valid permanent Oklahoma license as a registered nurse as approved by the Oklahoma Board of Nursing or Registered Nurse License recognized by the Enhanced Nurse Licensure Compact (eNLC)
AND
2years of professional nursing experience.
Experience as an Exceptional Needs Coordinator, Nurse Case Manager or Quality Assurance/Utilization Review Nurse
Advanced Health-related Education (e.g.MSN)
Experience with the Uniform Comprehensive Assessment Tool (UCAT)
Experience with aged, blind or disabled population
Experience with Medicaid/SoonerCare
Related Professional Certifications (other than BLS/ALS/PALS)
Experience with MS , Excel, Access, PowerPoint
Bilingual
Work is typically performed in an office setting with climate-controlled settings and exposure to moderate noise levels. In the course of performing job duties, employees are required to speak, stand, walk, and reach with their hands and arms. This position requires extended periods of sitting and daily use of computers and phones. Employees must be willing to complete all job-related travel associated with this position. Being present at the office is an essential function of this position.
The Oklahoma Health Care Authority complies with applicable State and Federal civil rights laws and does not discriminate. All qualified applicants will receive consideration for employment without regard to race, color, sex, religion, disability, age, national origin, or genetic information. If a reasonable accommodation is needed to participate in the job application or interview process, to perform essential job functions, and/or to receive other benefits and privileges of employment, please contact the Civil Rights Coordinator at 405-522-7335.
Notice to applicants:
Please add OHCAHR@okhca.org to the address book or “safe-senders” list in your email. All correspondence will come from this address. Be sure to check your junk folder. If you have questions about the status of your application, you can contact the HR team at 405-522-7093.
Note: Applications will be accepted until 11:59 PM on the day prior to the posting end date above.
Current State of Oklahoma employees must apply for open positions internally through Workday Jobs Hub
Equal Opportunity Employment
The State of Oklahoma is an equal opportunity employer and does not discriminate on the basis of genetic information, race, religion, color, sex, age, national origin, or disability.
Current active State of Oklahoma employees must apply for open positions internally through the Workday Jobs Hub
If you are needing any extra assistance or have any questions relating to a job you have applied for, please click the link below and find the agency for which you applied for additional information:
The State of Oklahoma provides services to Oklahomans via roughly 30,000 state employees working across dozens of state agencies.
