• National Utilization

    Humana (Oklahoma City, OK)
    **Become a part of our caring community and help us put health first** The Utilization Management (UM) Director , Clinical Strategy and Practice for Medicaid ... of how organization capabilities interrelate across the function or segment. The Utilization Management (UM) Director , Clinical Strategy and Practice… more
    Humana (06/06/25)
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  • AVP, Utilization Review & Pharmacy

    Zurich NA (Oklahoma City, OK)
    …+ Experience in development and implementation of cost containment programs + Case management , utilization review, catastrophic or disability experience + 5 or ... AVP, Utilization Review & Pharmacy 123092 Zurich Insurance is...recruiting and retaining team members. + Drive the performance management process by communicating job expectations, monitoring and evaluating… more
    Zurich NA (05/22/25)
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  • Medical Director - Medicaid N. Central

    Humana (Oklahoma City, OK)
    …to the Lead Medical Director - North Central Medicaid Markets. The Medical Director conducts Utilization Management of the care received by members in ... community and help us put health first** The Medical Director relies on medical background and reviews health claims....with prior experience participating in teams focusing on quality management , utilization management , case … more
    Humana (05/14/25)
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  • Medical Director , MSK Surgery

    Evolent (Oklahoma City, OK)
    …classes as needed for new hires to educate and train on Utilization management system and Field Medical Director process, standards and resources. + Acts as ... for the culture. **What You'll Be Doing:** The Medical Director for MSK Surgery is a key member of...reviews appeal cases and/or attends hearings for discussion of utilization management decisions. + Strong partnership with… more
    Evolent (05/20/25)
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  • Medical Director - Care Plus - Florida

    Humana (Oklahoma City, OK)
    Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in ... community and help us put health first** The Medical Director relies on medical background and reviews health claims....with prior experience participating in teams focusing on quality management , utilization management , case … more
    Humana (04/24/25)
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  • Field Medical Director , Interventional…

    Evolent (Oklahoma City, OK)
    …impact on patient care in a non-clinical setting? Join our Utilization Management team as a Field Medical Director , Cardiovascular Specialist and use your ... Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. +… more
    Evolent (04/30/25)
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  • Medical Director - Florida

    Humana (Oklahoma City, OK)
    Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in ... community and help us put health first** The Medical Director relies on medical background and reviews health claims....with prior experience participating in teams focusing on quality management , utilization management , case … more
    Humana (06/05/25)
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  • Medical Director - OneHome

    Humana (Oklahoma City, OK)
    …Medical Director , depending on size of team or line of business. The Medical Director conducts Utilization Management of the care received by members in ... community and help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on...with prior experience participating in teams focusing on quality management , utilization management , case … more
    Humana (05/31/25)
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  • Field Medical Director , Vascular Surgery

    Evolent (Oklahoma City, OK)
    …Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. + ... you will be a key member of the utilization management team. We can offer you... and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National more
    Evolent (06/06/25)
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  • Field Medical Director , Cardiology

    Evolent (Oklahoma City, OK)
    …Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. + ... you will be a key member of the utilization management team. We can offer you... and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National more
    Evolent (05/16/25)
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  • Regional Field Director , RNS Program…

    United Therapeutics (Oklahoma City, OK)
    …is innovative and inspiring where you can truly make a difference. The Regional Field Director , RNS Program Management serves as a director of all clinical ... the commercial non-promotional team. In addition, the Regional Field Director , RNS Program Management will: + Serve...initiation of a UT product, adverse effect mitigation, device utilization , and dosing upon request + Support the Clinical… more
    United Therapeutics (06/05/25)
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  • Capacity & Resource Management

    Grant Thornton (Oklahoma City, OK)
    …to share strategy, to implement process improvements and to roll out capacity management strategies to maximize utilization and drive operational excellence + ... Grant Thornton is seeking an Advisory Capacity & Resource Management (C&RM) Leader to join the team. Approved office...on yearly budget planning for headcount, gross charge hours, utilization , and leverage. You will lead your team to… more
    Grant Thornton (05/09/25)
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  • Medical Director -Payment Integrity

    Humana (Oklahoma City, OK)
    …interpretation skills, with prior experience participating in teams focusing on quality management , utilization management , case management , discharge ... Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management . + Utilization management experience in a… more
    Humana (06/06/25)
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  • Director of Customer Management

    Lumen (Oklahoma City, OK)
    …we digitally connect the world and shape the future. **The Role** The Audience Management Director will be responsible for leading the strategy and execution of ... them into actionable insights that drive competitive advantage and innovation. Strategic Utilization of Adobe CDP and Advanced Toolsets: + Implement a cohesive… more
    Lumen (05/31/25)
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  • Field Medical Director , Physical Medicine…

    Evolent (Oklahoma City, OK)
    …Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. + ... Rehab you will be a key member of the utilization management team. We can offer you... and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National more
    Evolent (05/30/25)
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  • Field Medical Director , Oncology

    Evolent (Oklahoma City, OK)
    …Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. . ... Oncology, you will be a key member of the utilization management team. We can offer you... and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National more
    Evolent (05/20/25)
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  • Medical Director (PRN)

    Centene Corporation (Oklahoma City, OK)
    …VP of Clinical Programs to direct and coordinate the physician component of the utilization management functions for the health plan business units. + Provides ... million members as a clinical professional on our Medical Management /Health Services team. Centene is a diversified, national...medical leadership for utilization management activities and medical review activities… more
    Centene Corporation (05/30/25)
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  • Associate Director , Client Analytics

    Evolent (Oklahoma City, OK)
    …leadership is preferred. + Familiarity with value-based care models and utilization management frameworks is preferred. **Technical Requirements:** We require ... of our specialty programs and administrative platform. **Role Overview** The Associate Director role on Client Analytics will support both internal teams (EAS,… more
    Evolent (05/01/25)
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  • Associate Director , Channel Strategy…

    Otsuka America Pharmaceutical Inc. (Oklahoma City, OK)
    **Associate Director , Channel Strategy and Patient Affordability** The Associate Director , Channel Strategy and Patient Affordability reports to the Executive ... Director , Channel Strategy and Patient Affordability. The Associate ...resources effectively across the team to ensure efficient budget utilization , while identifying cost saving opportunities + Design operational… more
    Otsuka America Pharmaceutical Inc. (05/29/25)
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  • Corporate Medical Director - Medicare…

    Humana (Oklahoma City, OK)
    …focused on continuously improving consumer experiences **Preferred Qualifications** + Medical utilization management experience + Working with health insurance ... our caring community and help us put health first** The Corporate Medical Director (CMD) relies on medical background to review health claims and preservice appeals.… more
    Humana (04/24/25)
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