Care Management Extender - Level I - Children's Behavioral Health Center (Fall 2026)

OU Health

About The Position

Our NEW Pediatric Behavioral Health Center is scheduled to open in December 2026. Candidates applying for this position should expect a start date after September 1, 2026. All applicants must be 21 years of age or older and provide two professional references as part of the hiring process. The Care Management Extender (CME) provides non-licensed, clerical and administrative support to the Utilization Review RN Case Managers to obtain Authorizations from payers, documenting the authorizations and or denials and bed days within the electronic medical record. Duties include but are not limited to, calling or faxing Protected Patient Health Information clinicals from the electronic medical record for patients admitted for care. Submitting Patient clinical information on approved payer portals. Assist with completing the bed days and authorization for all admitted and discharged patients. Providing general administrative support to Utilization Review Team.

Requirements

High School Diploma or GED required.
0-3 years of work experience, health care experience preferred.
None
Working knowledge of medical systems and medical terminology or complete department approved training within 1 month of hire.
Knowledge of CMS regulations, payment systems, Insurance Payer Portals within 1 month of hire.
Knowledge payer issues concerning reimbursement and regulatory perimeters or acquisition within 1 month of hire.
In-depth understanding of typical insurance benefit plans regarding coverage or acquisition within 1 month of hire.
Must be proficient with basic computer skills (word processing, excel spreadsheet, electronic fax, payer portals, emails, EPIC system).
Excellent typing skills.
Ability to work independently, manage time and prioritize department needs.
Able to adapt to frequent changes in direction.
Excellent interpersonal and communications skills with nursing staff, physicians, nurse practitioners and other health workers.
Ability to meet deadlines and manage multiple priorities, and effectively adapt and respond to complex, fast-paced, rapidly growing, and results-oriented environments.
Able to work in a dynamic, fast-paced team environment and to promote team concepts.
Excellent verbal and written communication skills.
Excellent interpersonal skills and ability to maintain composure in difficult situations.

Responsibilities

Assists RN Utilization Review Case Manager in submitting PHI clinical information to payers by fax or submitting clinical on payer portals.
Follows up on submission of clinicals by obtaining authorization , approved bed days or denial information and documents appropriately in the EMR.
Assists RN Utilization Review Case Manager in documenting payer communications within the EMR and completing approved or denied bed days up to 7 days post discharge from facilities.
Maintain patient confidentiality of all communications and documents as required by hospital policy and as regulated by HIPPA
Enters data into multiple systems and submits appropriate information in a timely fashion to facilitate Authorizations of payment are completed on the charts.
Identifies and escalates accounts to UR RN / Leadership to ensure CMS regulatory letters that have been completed appropriately by the Utilization Review Nurse.
Responds to inquiries, maintains and revises record keeping and filing systems; classifies, sorts, and files correspondence, articles, records, and other documents.
Performs other related duties and special projects as assigned.
Performs other duties as assigned.