Oklahoma Licensed Utilization Review RN

Job Summary

Collaborating with healthcare providers and insurance companies, the full-time Oklahoma Licensed Utilization Review RN will conduct comprehensive patient assessments, coordinate care, and ensure compliance with healthcare regulations while working remotely from designated states.

Key responsibilities

• Conduct comprehensive assessments of patients' health status and ongoing care needs using evidence-based criteria
• Coordinate with interdisciplinary teams, patients, and payors to ensure appropriate care status and financial reimbursement
• Educate patients and families on healthcare processes and compliance with regulatory and financial expectations

Required qualifications

• Associate's Degree in Nursing required for Level 1; Bachelor's Degree in Nursing required for Levels 2 and 3
• 0-3 years of RN experience required for Level 1; at least 3 years of Care Management experience for Level 2; 5 or more years for Level 3
• Current Registered Nurse License issued by the Oklahoma State Board of Nursing or a current multistate compact Registered Nurse (eNLC)