• Utilization Management…

    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 ... action. + Minimum one, (1) year of experience in Behavioral Health Nursing (inpatient outpatient, psych, substance...Nursing experience + Previous experience in utilization management with ASAM knowledge + Health Plan… more
    Humana (05/13/25)
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  • Coordinator, Utilization Management

    Evolent (Oklahoma City, OK)
    …the mission. Stay for the culture. **What You'll Be Doing:** The **Coordinator, Intake Utilization Management ** at Evolent will serve as a point of contact for ... and client contractual agreements. **Collaboration Opportunities** : The Coordinator, Intake Utilization Management reports directly to the Manager, … more
    Evolent (05/03/25)
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  • Registered Nurse, Laureate Senior…

    Saint Francis Health System (Tulsa, OK)
    …Skills and Abilities: Working knowledge of general disease state management processes, bio-psychosocial model, and clinical pathways. Effective interpersonal, ... toward goals. Facilitates patient discharge through timely, appropriate referrals and utilization of patient education resources, suitable to patient age and… more
    Saint Francis Health System (04/09/25)
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  • Behavioral Health Case Manager I

    Saint Francis Health System (Muskogee, OK)
    …members; attends interdisciplinary/treatment team and patient planning meetings. Coordinate case management with utilization management . Decision Making: ... and effective patient outcomes. Minimum Education: Bachelor's Degree in a health related field. Licensure, Registration and/or Certification: None. Work Experience:… more
    Saint Francis Health System (04/09/25)
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  • Transition of Care Coordinator

    CVS Health (Oklahoma City, OK)
    …discharge with adequate supervision, recommended behavioral health , physical health , pharmacy resources, and care management support. + Educates and ... every day. **Summary** : The Transition of Care Coordinator Behavioral Health utilizes advanced clinical judgment and...care to meet the member's goals. + Utilizes case management , utilization management , and quality… more
    CVS Health (05/15/25)
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  • Transplant Care Nurse RN - Stem Cell, Bone Marrow…

    Highmark Health (Oklahoma City, OK)
    …of clinical, case/ utilization management and/or disease/condition management experience, or provider operations and/or health insurance experience ... health status/severity and clinical needs; and assesses health management needs of the assigned member...clinical care is being provided. **Preferred** + Certification in utilization management or a related field +… more
    Highmark Health (04/25/25)
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  • Client Benefit Analyst

    Highmark Health (Oklahoma City, OK)
    …(Claims, Dental Benefits, Customer Service, Membership & Billing), Provider Data Management , Underwriting, and Professional Relations. **This role will support the ... including gathering data from multiple sources related to Benefit/Claim Utilization , Enrollment, Networks ( utilization , disruption, geo-access) and making… more
    Highmark Health (04/24/25)
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  • Part-Time Weekend Medical Director (Remote)

    Highmark Health (Oklahoma City, OK)
    …:** **JOB SUMMARY** This job, as part of a physician team, ensures that utilization management responsibilities are performed in accordance with the highest and ... (DO) **Substitutions** + None **Preferred** + Master's Degree in Business Administration/ Management or Public Health **EXPERIENCE** **Required** + 5 years… more
    Highmark Health (03/14/25)
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  • Client Project Manager

    Highmark Health (Oklahoma City, OK)
    …and leadership from more senior Delivery Owners. The incumbent provides project management leadership and facilitates the delivery of system changes from approval ... through to release to production. The leadership provided includes all project management outputs as well as extensive communication with business stakeholders both… more
    Highmark Health (05/16/25)
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  • Cloud FinOps Manager

    Highmark Health (Oklahoma City, OK)
    …with strong analytical and communication skills. **ESSENTIAL RESPONSIBILITIES** + Perform management responsibilities to include, but are not limited to: involved in ... termination decisions, coaching and development, rewards and recognition, performance management and staff productivity.Plan, organize, staff, direct and control the… more
    Highmark Health (04/16/25)
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