- 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 ... Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact by performing advanced...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 ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...in an acute care setting + Previous experience in utilization management / utilization review … more
- Evolent (Oklahoma City, OK)
- …the mission. Stay for the culture. **What You'll Be Doing:** The Clinical Review Nurse is responsible for performing precertification and prior approvals. Tasks ... physician-developed medical policies, and clinical decision-making criteria sets. The Clinical Review Nurse serves as a member advocate, expediting care… more
- US Tech Solutions (May, OK)
- …MUST HAVE MANAGED CARE exp and Medicare/Medicaid knowledge. . MUST HAVE UM experience, inpatient utilization management review . . MUST HAVE 1 YEAR OF ... policy, regulatory and accreditation guidelines. . Responsible for the review and evaluation of clinical information and documentation. ....UTILIZATION MANAGEMENT EXP, pref. knowledge of Milliman/MCG. . MUST HAVE… 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
- Saint Francis Health System (Tulsa, OK)
- …their family-providing support and encouragement. Work closely with social work, case management , nurse navigators to provide information of discharge planning. ... of Surgical, ortho, neuro and hospice / comfort measures. Utilization of hands-on skills Play an important role in...improving the care for Health System Elders: is a nurse driven program designed to help hospitals and health… more
- Evolent (Oklahoma City, OK)
- …team focusing on appeals and post-determination requests. We maintain the principles of utilization management by adhering to Evolent and Client policies and ... 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 … more
- Saint Francis Health System (Muskogee, OK)
- …**to login and apply.** Full Time Nights **Registered Nurse Full-time ICU** **Adult Intensive Care Unit** **6-12 months ... Registered Nurse experience required** Staff floats to other areas as...Skills and Abilities: Working knowledge of general disease state management processes, bio-psychosocial model, and clinical pathways. Effective interpersonal,… more
- Saint Francis Health System (Muskogee, OK)
- …as needed by the department; limited benefit offerings. Variable **Registered Nurse ECB Geriatric Psych** Adult patients with dementia, depression, Alzheimer's, and ... 12-hour shift on each of 2 designated holidays Job Summary: The Registered Nurse I assesses, plans, implements and evaluates nursing care, utilizing the nursing… more
- Saint Francis Health System (Tulsa, OK)
- …team environment. Our nursing staff work closely with Cardiology, Hospitalists, and Case Management teams. This unit is perfect for seasoned nurses and also provides ... 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
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