- Humana (Oklahoma City, OK)
- …a part of our caring community and help us put health first** The Corporate Medical Director (CMD) relies on medical background to review health claims ... and preservice appeals. The Corporate Medical Director works on problems of diverse...experience + Knowledge of the managed care industry including Medicare , Medicaid and/or Commercial products + Must be passionate… more
- Humana (Oklahoma City, OK)
- …a part of our caring community and help us put health first** The Corporate Medical Director relies on medical background and reviews health claims and ... preservice appeals. The Corporate Medical Director works on problems of diverse...experience + Knowledge of the managed care industry including Medicare , Medicaid and or Commercial products + Must be… more
- Cognizant (Oklahoma City, OK)
- …. Draft and submit the medical necessity determinations to the Health Plan/ Medical Director based on the review of clinical documentation in accordance with ... Plan/Payer. The comprehensive process includes analyzing, reviewing, and processing medical necessity denials for resolution. You will be a... Medicare , Medicaid, and third-party guidelines. . Effectively document and… more
- Saint Francis Health System (Tulsa, OK)
- …experience. Warehouse, shipping and receiving or materials management experience with medical field knowledge. Knowledge, Skills and Abilities: Knowledge of ... Medicare , TJC, federal and state regulations. Demonstrated effective management...of subordinates. Maintains positive relationships among workers and resolves grievances . Prepares composite reports from individual reports of subordinates.… more