- US Tech Solutions (May, OK)
- …HAVE MANAGED CARE exp and Medicare/Medicaid knowledge. . MUST HAVE UM experience, inpatient utilization management review . . MUST HAVE 1 YEAR OF UTILIZATION ... policy, regulatory and accreditation guidelines. . Responsible for the review and evaluation of clinical information and documentation. ..... 1+ years of inpatient hospital experience . Registered Nurse in state of residence . Must have prior… more
- Ascension Health (Tulsa, OK)
- …planning needs with healthcare team members. + May prepare statistical analysis and utilization review reports as necessary. + Oversee and coordinate compliance ... licensure at time of hire. **Additional Preferences** + 5+ years RN experience + Utilization Review experience preferred **Why Join Our Team** Ascension St. John… more
- Saint Francis Health System (Tulsa, OK)
- …Telemetry Units. Overflow of Surgical, ortho, neuro and hospice / comfort measures. Utilization of hands-on skills Play an important role in not only the patient's ... support and encouragement. Work closely with social work, case management, nurse navigators to provide information of discharge planning. Family oriented… more
- CVS Health (Oklahoma City, OK)
- …with transferring patients to lower levels of care. + 1+ years' experience in Utilization Review . + CCM and/or other URAC recognized accreditation preferred. + ... AHH is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical management services that support… more
- CVS Health (Oklahoma City, OK)
- …with transferring patients to lower levels of care. - 1+ years' experience in Utilization Review . - CCM and/or other URAC recognized accreditation preferred - 1+ ... AHH is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical management services that support… more
- Sharecare (Oklahoma City, OK)
- …appropriate total healthcare management and ensure cost effective, appropriate resource utilization and quality outcomes. The Clinical Registered Nurse is ... To learn more, visit www.sharecare.com . **Job Summary:** The Clinical Registered Nurse has the responsibility for supporting the goals and objectives of the… more
- Saint Francis Health System (Muskogee, OK)
- …**to login and apply.** Full Time Nights **Registered Nurse Fulltime Emergency Room** Primary Stroke Center in Oklahoma ... 6-12 months experience Registered Nurse experience required Emergency Room experience strongly preferred **Requires** 36 hours per week (3) 12-hour shifts Weekends… more
- Saint Francis Health System (Muskogee, OK)
- …hours per month as needed by the department; limited benefit offerings. Days **Registered Nurse ECB Outpatient Infusion** . Not available for New Grad RNs 2-3 years ... No on-call **Requires** 36 hours per schedule Job Summary: The Registered Nurse I assesses, plans, implements and evaluates nursing care, utilizing the nursing… more
- Lincoln Financial (Oklahoma City, OK)
- …Coronary Care, , Trauma , Disability, Workman's comp or case management or Utilization review **Application Deadline** **What's it like to work here?** At ... We are excited to bring on a highly motivated Nurse Disability Consultant to our clinical organization. This position...in a career at Lincoln, we encourage you to review our current openings and apply on our website.… more
- Saint Francis Health System (Tulsa, OK)
- …Licensure, Registration and/or Certification: Valid multi-state or State of Oklahoma Registered Nurse License. Work Experience: Minimum of 1 year in PACU and related ... disorders. Basic PC skills as required for electronic documentation and data review . Essential Functions and Responsibilities: Uses the nursing process and physician… more
- Saint Francis Health System (Tulsa, OK)
- …offerings. Nights 7p - 7a ECB Flexible Schedule Job Summary: The Registered Nurse I assesses, plans, implements and evaluates nursing care, utilizing the nursing ... Registration and/or Certification: Valid multi-state or State of Oklahoma Registered Nurse License. Work Experience: 0 - 6 months related experience. Knowledge,… more
- Saint Francis Health System (Tulsa, OK)
- …and grow. Come join our team today! \#RNSIND Job Summary: The Registered Nurse I assesses, plans, implements and evaluates nursing care, utilizing the nursing ... Registration and/or Certification: Valid multi-state or State of Oklahoma Registered Nurse License. Work Experience: 0 - 6 months related experience. Knowledge,… more
- Evolent (Oklahoma City, OK)
- …focusing on appeals and post-determination requests. We maintain the principles of utilization management by adhering to Evolent and Client policies and procedures ... work with a group of nurses, providing appeal intake review for one dedicated client. They interact with coordinators...Be Doing:** + Practices and maintains the principles of utilization management and appeals management by adhering to company… more
- Highmark Health (Oklahoma City, OK)
- …**Job Description :** **JOB SUMMARY** This job implements effective complimentary utilization and case management strategies for an assigned member panel. Provides ... to appropriate resources for additional support. + Implement care management review processes that are consistent with established industry, corporate, state, and… more
- Fresenius Medical Center (Yukon, OK)
- …auditing activities. + Accountable for completion of the Annual Standing Order Review and Internal Classification of Disease (ICD) coding. + Manages clinic ... financials including efficient utilization of supplies or equipment and regular profits and...of supplies or equipment and regular profits and loss review . + Responsible for all required network reporting and… more
- Highmark Health (Oklahoma City, OK)
- …regulatory requirements. Document, process and route requests for services to the nurse reviewer and other departments based on documentation procedures, including ... review type, clinical information, and decision timeframes. Follow policies...and notification requirements are met + Communicate effectively with Utilization Management Staff, providers, other internal and external customers… more
- Evolent (Oklahoma City, OK)
- …years of direct clinical patient care + **Minimum one year of experience with Utilization Review (UM) in a managed care environment** + **Cardiology and Oncology ... + Performs other duties as assigned. **Qualifications: Required and Preferred:** + Licensed registered nurse or LVN/LPN (current and unrestricted) + Minimum of three… more