• Clinical Case Manager

    CVS Health (Oklahoma City, OK)
    …issues. * Using advanced clinical skills, performs crisis intervention with members experiencing behavioral health or medical crisis and refers them to the ... care issues through established channels * Ability to speak to medical and behavioral health professionals to influence appropriate member care. * Utilizes… more
    CVS Health (06/23/25)
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  • Case Manager - Behavioral

    SSM Health (Oklahoma City, OK)
    …Anthony Hospital - Oklahoma City **Worker Type:** Regular **Job Highlights:** . Department: Behavioral Health . Schedule: Full Time, Days​ . Starting Pay: ... to feel valued while respecting teamwork and collaboration. Our Case Management roles are an integral piece in our...and we see it as a partnership. At SSM Health , we know the healing power of presence begins… more
    SSM Health (06/08/25)
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  • Manager , UM Behavioral

    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
    Humana (06/26/25)
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  • Transition of Care Coordinator Registered Nurse

    CVS Health (Oklahoma City, OK)
    …Office Suite applications (Teams, Outlook, Word, Excel, etc.) - Successfully complete the Behavioral Health Case Manager certification training provided ... Model. - Ensures members transition upon discharge with adequate supervision, recommended behavioral health , physical health , pharmacy resources, and care… more
    CVS Health (06/23/25)
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  • Complex Case Manager RN - Oncology…

    Highmark Health (Oklahoma City, OK)
    …ownership and oversight over a specified panel of members that range in health status/severity and clinical needs. The incumbent assesses health management needs ... interventions and referrals, the incumbent will manage an active case load of members in his/her panel that are...various resources to assist members in achieving their personal health goals. The incumbent monitors, improves and maintains quality… more
    Highmark Health (04/25/25)
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  • Telephonic Nurse Case Manager

    Humana (Oklahoma City, OK)
    …part of our caring community and help us put health first** The **Telephonic Nurse Case Manager ** will be a member of the Case Management Team, providing ... case management throughout the continuum of care. The case manager will offer guidance. support, and...the beneficiary for all activities within the medical and behavioral health spectrum. They will also coordinate… more
    Humana (07/01/25)
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  • Manager Strategic Risk Adjustment Programs

    Highmark Health (Oklahoma City, OK)
    …and existing Risk Adjustment Programs. The incumbent will deliver value to the Health Plan, and its beneficiaries enrolled in Risk Adjusted government programs (MA ... the engagement deliverables, resources, and outcomes. + Develop the engagement business case , scope, staffing and incentive model for RPM engagement with Providers… more
    Highmark Health (06/05/25)
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  • Coding Auditor Educator

    Highmark Health (Oklahoma City, OK)
    **Company :** Allegheny Health Network **Job Description :** **GENERAL OVERVIEW:** Performs all related internal, concurrent, prospective and retrospective coding ... works with external resources to create and monitor inpatient case mix reports and the top 25 assigned DRGs/APCs...of Ethical Coding as set forth by the American Health Information Management Association and Corporate Compliance Coding Guidelines.… more
    Highmark Health (05/09/25)
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  • Compliance Nurse 2

    CenterWell (Oklahoma City, OK)
    …+ Previous Medicare/Medicaid experience a plus + Previous experience in utilization management, case management, discharge planning and/or home health or rehab + ... and for the lowest cost. We go beyond physical health - addressing the social, emotional, behavioral ...primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager more
    CenterWell (07/01/25)
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  • Senior Strategy Advancement Professional

    CenterWell (Oklahoma City, OK)
    …that impact patient well-being. Our integrated care teams, which include physicians, nurses, behavioral health specialists and more, spend up to 50 percent more ... ad hoc reporting. * Develop basic modeling and business case analysis; work closely with Finance and Data teams...primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager more
    CenterWell (06/24/25)
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  • Clinical Staff Pharmacist

    KPH Healthcare Services, Inc. (Oklahoma City, OK)
    **Overview** **Job Summary:** Under the supervision of the pharmacy manager and/or pharmacy supervisor, performs all duties necessary to provide for the efficient ... policies as it relates to the provision of the highest quality health care service to our patients. **Responsibilities** **Job Duties:** + Ensures compliance… more
    KPH Healthcare Services, Inc. (04/16/25)
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