- Humana (Oklahoma City, OK)
- …a part of our caring community and help us put health first** The Manager , Utilization Management Behavioral Health utilizes behavioral health ... and communication of medical services and/or benefit administration determinations. The Manager , Utilization Management Behavioral Health works within… more
- Highmark Health (Oklahoma City, OK)
- …panel. Provides oversight over a specified panel of members that range in health status/severity and clinical needs; and assesses health management needs of ... various resources to assist members in achieving their personal health goals. Will work with providers to insure quality...and federal law standards and are within the care manager 's professional discipline. + For assigned case load, create… more
- Highmark Health (Oklahoma City, OK)
- **Company :** Highmark Health **Job Description :** **JOB SUMMARY** This job implements effective utilization management strategies including: review of ... appropriateness of health care services, application of criteria to ensure appropriate...industry and corporate standards and are within the care manager 's professional discipline. + Function in accordance with applicable… more
- Highmark Health (Oklahoma City, OK)
- …this strategy, including retail and mail network optimization, rebate, formulary & UM financial optimization, and additional programs to meet segment growth and ... management, rebate contracting opportunities, and pharmacy programs (network, formulary, UM , buy-up's) to achieve segment specific pharmacy enrollment and financial… more