- Zurich NA (Oklahoma City, OK)
- …+ Experience in development and implementation of cost containment programs + Case management , utilization review , catastrophic or disability experience + 5 ... AVP, Utilization Review & Pharmacy 123092 Zurich...recruiting and retaining team members. + Drive the performance management process by communicating job expectations, monitoring and evaluating… more
- Evolent (Oklahoma City, OK)
- …LMSWs, LCSW, and LPCs, Clinical Reviewers. Opportunities to work collaboratively with other Utilization Management Leaders including our Director may also be ... the culture. **What You'll Be Doing:** The **Coordinator, Intake Utilization Management ** at Evolent will serve as...to determine if submitted requests require a prior authorization review or redirect as required. + Entering data into… more
- Evolent (Oklahoma City, OK)
- …Clinical Reviewer, Interventional Pain Management , you will be a key member of the utilization management team. We can offer you a meaningful way to make a ... utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National Committee for Quality… more
- 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 ... the support services review process. Responsible for the quality of utilization review determinations, including appeals. + Provides input into audit… more
- Humana (Oklahoma City, OK)
- …. + Utilization management experience in a medical management review organization, such as Medicare Advantage, managed Medicaid, or Commercial ... operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately...Director - North Central Medicaid Markets. The Medical Director conducts Utilization Management of… more
- 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
- Genesis Healthcare (Oklahoma City, OK)
- …Area Director ). 9. Assumes responsibility for daily staffing and utilization with input from treating therapists, consideration of clinical requirements, and ... of the rehabilitation department, including oversight related to case management , quality improvement, care planning, clinical utilization , and patient… more
- Humana (Oklahoma City, OK)
- …. + Utilization management experience in a medical management review organization, such as Medicare Advantage, managed Medicaid, or Commercial ... operationalize this knowledge in their daily work. The Medical Director 's work includes computer based review of...size of region or line of business. The Medical Director conducts Utilization Management of… more
- Humana (Oklahoma City, OK)
- …. + Utilization management experience in a medical management review organization, such as Medicare Advantage, managed Medicaid, or Commercial ... operationalize this knowledge in their daily work. The Medical Director 's work includes computer based review of...size of region or line of business. The Medical Director conducts Utilization Management of… more
- 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