- Prime Therapeutics (Oklahoma City, OK)
- …clinical experience. + Experience in managed care, specialty drugs, care management and utilization review . + Meets Credentialing criteria. + At minimum must ... drives every decision we make. **Job Posting Title** Infusion Referral Nurse - REMOTE **Job Description** Under supervision, is responsible for performing referral… more
- Saint Francis Health System (Muskogee, OK)
- …**to login and apply.** Full Time Days **Registered Nurse Fulltime Radiology Diagnostic** . RN license to practice ... 71 miles . Shift Differentials . Employee Benefits Job Summary: The Registered Nurse I assesses, plans, implements and evaluates nursing care, utilizing the nursing… more
- Saint Francis Health System (Tulsa, OK)
- …length of stay.** + **The patient population is a wide variety of medical and surgical patients. Working closely with the Emergency Department.** Job Summary: ... Registration and/or Certification: Valid multi-state or State of Oklahoma Registered Nurse License. Work Experience: 1 - 2 years related experience. Knowledge,… more
- Saint Francis Health System (Tulsa, OK)
- …team of nursing professionals provide care for a wide variety of medical conditions including chest pain, atrial fibrillation, peripheral vascular disease, pulmonary ... and grow. Come join our team today! \#RNSIND Job Summary: The Registered Nurse I assesses, plans, implements and evaluates nursing care, utilizing the nursing… 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
- Sedgwick (Oklahoma City, OK)
- …narcotic use contract with client. + Maintains accurate record system of pharmacy utilization review and complex pharmacy reviews to include cost savings, ... and dosage, and monitor complex drug regimens; to provide medical necessity reviews to evaluate, implement, and monitor options...provider. + Calls treating physicians to conduct a peer review of medications used on specific claims and provides… more
- Humana (Oklahoma City, OK)
- …Medicare and Medicaid LOB - Medicare Clinical Criteria Review (MCCR), Utilization Management Committee (UMC), Medical Coverage Policy Adoption (MCPA) + ... medical coverage policies utilizing an evidence based medicine review process. **Location:** work at home anywhere Humana is...any field or equivalent experience + Active unrestricted Registered Nurse (RN) license + 5 years or more of… more
- CenterLight Health System (Stilwell, OK)
- …of experience in care/case management, disease management, population health management, utilization review , quality assurance, or discharge planning (preferably ... clinical onboarding and reassessment, UAS-NY completion, comprehensive assessment, medication review , and post-hospital discharge evaluation. The Clinical Assessment Manager… more