- CVS Health (Oklahoma City, OK)
- …And we do it all with heart, each and every day. **Position Summary:** The ** Utilization Management Clinical Nurse Consultant - Prior Authorization** ... internal and external constituents in the coordination and administration of the utilization /benefit management function. + Gathers clinical information and… more
- Cognizant (Oklahoma City, OK)
- …. Educational background - Registered Nurse (RN) . 2-3 years combined clinical and/or utilization management experience with managed health care plan ... 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 … more
- Humana (Oklahoma City, OK)
- …of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, ... determination of the appropriate courses of action. The Utilization Management Nurse 2 uses clinical knowledge, communication skills, and independent… more
- CVS Health (Oklahoma City, OK)
- … (UM) Nurse Consultant. As a Utilization Management Nurse Consultant, you will utilize clinical skills to coordinate, document and communicate all ... and state regulated turn-around times. This includes reviewing written clinical records. **Key Responsibilities of the UM Nurse...practice experience as an RN required. + 2+ Years Utilization Management experience. + Must be willing… more
- CVS Health (Oklahoma City, OK)
- …a psychiatric or behavioral health setting required. + Strong knowledge of clinical practice guidelines and utilization management . **Required** ... clinical skills to coordinate, document, and communicate all aspects of our utilization and benefit management programs. You'll apply critical thinking and… more
- US Tech Solutions (May, OK)
- …HAVE MANAGED CARE exp and Medicare/Medicaid knowledge. . MUST HAVE UM experience, inpatient utilization management review. . MUST HAVE 1 YEAR OF UTILIZATION ... and evaluates Potential Quality of Care issues based on clinical policies and benefit determinations. . Considers all documented.... 1+ years of inpatient hospital experience . Registered Nurse in state of residence . Must have prior… more
- CVS Health (Oklahoma City, OK)
- …internal and external constituents in the coordination and administration of the utilization /benefit management function. + Gathers clinical information and ... skills to coordinate, document, and communicate all aspects of the utilization /benefit management program. + Applies critical thinking and knowledge in… more
- CVS Health (Oklahoma City, OK)
- … skills to coordinate, document and communicate all aspects of the utilization /benefit management program. Applies critical thinking and is knowledgeable in ... and external constituents in the coordination and administration of the utilization /benefit management function. **Required Qualifications** + 3+ years post… more
- Saint Francis Health System (Tulsa, OK)
- …Licensure, Registration and/or Certification: Valid multi-state or State of Oklahoma Registered Nurse License, or Clinical Social Worker (LCSW), or Professional ... 8:00am - 12:00pm **OR** 1:00pm - 5:00pm Job Summary: Provides administrative and clinical support to the hospital and treatment team throughout the review of… more
- Evolent (Oklahoma City, OK)
- …for the mission. Stay for the culture. **What You'll Be Doing:** The Nurse Reviewer is responsible for performing precertification and prior approvals. Tasks are ... independent nursing judgement and decision-making, physician-developed medical policies, and clinical decision-making criteria sets. Acts as a member advocate by… more
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