- Cognizant (Oklahoma City, OK)
- …you need to have to be considered** . Educational background - Registered Nurse (RN) . 2-3 years combined clinical and/or utilization management ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...care revenue cycle or clinic operations . Experience in utilization management to include Clinical Appeals and… more
- Humana (Oklahoma City, OK)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... independent determination of the appropriate courses of action. The Utilization Management Nurse 2 uses clinical...skills to make an impact** **Required Qualifications** + Licensed Registered Nurse (RN) in the (appropriate state)… more
- Humana (Oklahoma City, OK)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... 7pm EST approximately 3-4 Thursday and Friday's annually. The Utilization Management Nurse 2 uses clinical...Qualifications** + Minimum of an Associate's degree + Licensed Registered Nurse (RN) with no disciplinary action… more
- CVS Health (Oklahoma City, OK)
- …both verbal and written **Required Qualifications** - 2+ years of experience as a Registered Nurse in adult acute care/critical care setting - Must have active ... all with heart, each and every day. **Position Summary** Utilization Management is a 24/7 operation and work schedules...will include weekends, holidays, and evening hours. * Utilizes clinical experience and skills in a collaborative process to… more
- CVS Health (Oklahoma City, OK)
- …+ Unrestricted OK state independent Behavioral Health clinicianlicense or a Registered Nurse (RN) with psychiatric specialty,certification, or Behavioral Health ... or behavioral health setting required. + Strong knowledge of clinical practice guidelines and utilization management. **Required**...Health licensure (LCSW, LPCC, LMFT, LPAT, LP) or a Registered Nurse (RN) with unrestricted state license… more
- CVS Health (Oklahoma City, OK)
- …good standing Arizona clinical and/or counseling license, specifically RN ( Registered Nurse ), LPC (Licensed Professional Counselor), LAC (Licensed Associate ... skills to coordinate, document, and communicate all aspects of the utilization /benefit management program. + Conduct clinical reviews for adult inpatient… more
- CVS Health (Oklahoma City, OK)
- …+ Perform medical necessity reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse with at least 1 year of experience in a hospital ... is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical management services that...setting. + A Registered Nurse that holds an active, unrestricted… more
- Humana (Oklahoma City, OK)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... independent determination of the appropriate courses of action. The Utilization Management Nurse 2 uses clinical...skills to make an impact** **Required Qualifications** + **Licensed Registered Nurse (RN)** in the (appropriate state)… more
- ERP International (Tinker AFB, OK)
- **Overview** ERP International, LLC is seeking a ** Registered Nurse - Case Manager** for a full-time position supporting **SHG Clinic** in support of **Tinker ... no limitations, stipulations or pending adverse actions) to practice nursing as a registered nurse in any US state/jurisdiction. Security** : Must possess… more
- CVS Health (Oklahoma City, OK)
- …of the team. The TCM is the primary member of the CVS Health clinical care team and facilitator of interdisciplinary collaboration and care continuity across care ... member-centered care; preventing avoidable readmissions; and managing efficient resource utilization . **We are recruiting TCMs who would be available to… more
- Sharecare (Oklahoma City, OK)
- …to drive cost effective and appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their ... to enable individuals with disabilities to perform the essential functions. + Current Registered Nurse multi-state compact license in the state in which they… more
- Select Medical (Oklahoma City, OK)
- **Overview** Nurse Manager- Registered Nurse (RN) Full-Time Days **Select Specialty Hospital-Oklahoma City** is a critical illness recovery hospital ... vulnerable, painful moments of their lives - and the Nurse Manager plays a central role in providing compassionate,...reimbursement, and continuing education + **Elevate Your Skills** : Clinical ladder programs and certifications such as PCCN and… more
- SSM Health (Oklahoma City, OK)
- …Department of Financial and Professional Regulation (IDFPR) State of Work Location: Missouri + Registered Nurse (RN) Issued by Compact State + Or + Registered ... regarding clinical data as it pertains to clinical outcomes, resource utilization , and clinical...of Professional Registration State of Work Location: Oklahoma + Registered Nurse (RN) Issued by Compact State… more
- SSM Health (Midwest City, OK)
- …Department of Financial and Professional Regulation (IDFPR) State of Work Location: Missouri + Registered Nurse (RN) Issued by Compact State + Or + Registered ... in standard work. + May also be responsible for: utilization management process, ED case management process, admission process,...of Professional Registration State of Work Location: Oklahoma + Registered Nurse (RN) Issued by Compact State… more
- Datavant (Oklahoma City, OK)
- …clinical knowledge and expertise successfully. Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well versed in DRG downgrade ... of the Denial Prevention Specialist is to effectively defend utilization of available health services, review of admissions for...by management Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well… more
- Highmark Health (Oklahoma City, OK)
- …years of experience in Managed Care **LICENSES or CERTIFICATIONS** **Required** + Registered Nurse **Preferred** + Certified Medical Coder or related **SKILLS** ... itemized bills, and claims data to assure appropriate level of payment and resource utilization . It is also used to identify issues which can be used for education… more