- 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
- Cognizant (Oklahoma City, OK)
- …background - Registered Nurse (RN) . 2-3 years combined clinical and/or utilization management experience with managed health care plan . 3 years' experience in ... Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact by performing advanced...as well as timely filing deadlines and processes. . Review clinical denials including but not limited to referral,… more
- Humana (Oklahoma City, OK)
- …Coordinator or discharge planner in an acute care setting + Previous experience in utilization management/ utilization review for a health plan or acute care ... our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination,… more
- CVS Health (Oklahoma City, OK)
- …rotating weekend and holiday schedules. **Preferred** **Qualifications** : + Managed care/ utilization review experience preferred + Experience in a behavioral ... skills to coordinate, document, and communicate all aspects of our utilization and benefit management programs. You'll apply critical thinking and evidence-based… more
- CVS Health (Oklahoma City, OK)
- …with behavioral health background. **Preferred Qualifications** + 3 years Managed care/ utilization review experience preferred. + Crisis intervention skills and ... skills to coordinate, document and communicate all aspects of the utilization /benefit management program. Applies critical thinking and is knowledgeable in… more
- Saint Francis Health System (Tulsa, OK)
- …participates in the Patient Care Committee for patient care reviews, and in Utilization Review Staff Committee, providing data and contributing to improvement of ... administrative and clinical support to the hospital and treatment team throughout the review of patients, their placement in various levels of care and their receipt… more
- Veterans Affairs, Veterans Health Administration (Muskogee, OK)
- …intimate knowledge of the internal referral care process, clinical review criteria, utilization management standards, clinical documentation requirements, ... Veterans Act of 2016. Responsibilities The Community Care (CC) Coordinator Registered Nurse (RN) is responsible for executing a streamlined approach to receiving,… more
- Humana (Oklahoma City, OK)
- …Office products including Word, Excel and Outlook **Preferred Qualifications** + Utilization Review /Quality Management experience + Experience working with MCG ... a part of our caring community and help us put health first** The Appeals Nurse 2 resolves clinical complaints and appeals. The Appeals Nurse 2 work assignments… 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
- Sharecare (Oklahoma City, OK)
- … utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants for identification ... more, visit www.sharecare.com . **Job Summary:** The Disease Management Nurse has the responsibility for supporting the goals and...and to take the pre and post tests to review competency during orientation. Yearly competency tests are required… more
- Saint Francis Health System (Tulsa, OK)
- …7p - 7a, rotating weekends Minimum of 5 years bedside experience preferred. Virtual Nurse works from an on-site office location (not a remote position) Will perform ... admit, discharge chart review and other patient care duties via secure virtual...link to patient rooms \#RNSIND Job Summary: The Registered Nurse I (Virtual) assesses, plans, implements and evaluates nursing… more
- HCA Healthcare (Oklahoma City, OK)
- …from any other healthcare provider. We are seeking an Operating Room Registered Nurse to join our healthcare family. **Benefits** Oklahoma Surgicare, offers a total ... nurses play a vital part. We know that every nurse 's path and purpose is unique. Do you want...the instrument and equipment set-up for your OR, including utilization of preference cards and ability to anticipate your… more
- Evolent (Oklahoma City, OK)
- …quality and cost effective care delivery. **What You'll Be Doing:** + Performs utilization review of outpatient procedures and ancillary services. + Fulfills on ... for the mission. Stay for the culture. **What You'll Be Doing:** The Nurse Reviewer is responsible for performing precertification and prior approvals. Tasks are… more
- Saint Francis Health System (Muskogee, OK)
- …**to login and apply.** Full Time Nights **Registered Nurse Full-time ICU** **Adult Intensive Care Unit** **ICU experience ... required** **6-12 months Registered Nurse experience required** Staff floats to other areas as...goals. Facilitates patient discharge through timely, appropriate referrals and utilization of patient education resources, suitable to patient age… more
- Saint Francis Health System (Muskogee, OK)
- …month as needed by the department; limited benefit offerings. Nights **Registered Nurse ECB Women's Services** Registered Nurse Experience required **36 hours ... 12-hour shift on each of two designated holidays** Job Summary: The Registered Nurse I assesses, plans, implements and evaluates nursing care, utilizing the nursing… more
- Fresenius Medical Center (Oklahoma City, OK)
- **PURPOSE AND SCOPE:** The Inpatient Services Charge Nurse is an additional "responsibility" assigned to the Inpatient Services RN, for a limited period of time, and ... duties, as assigned by the Program Manager. The Inpatient Services Charge Nurse ensures appropriate provision of Acute Dialysis Services and treatments within… 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
- Saint Francis Health System (Tulsa, OK)
- …patients in PACU, Critical Care or ER areas Job Summary: The Registered Nurse I assesses, plans, implements and evaluates nursing care, utilizing the nursing process ... Registration and/or Certification: Valid multi-state or State of Oklahoma Registered Nurse License. Work Experience: Minimum 2 years of PACU, Critical Care… more
- Saint Francis Health System (Tulsa, OK)
- …Registration and/or Certification: Valid multi-state or State of Oklahoma Registered Nurse License. Work Experience: 1 - 2 years related experience. Knowledge, ... 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)
- …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