- OU Health (Oklahoma City, OK)
- Position Title:Manager Case Management Utilization Review - OU Medical CenterDepartment:Case ManagementJob Description:General Description: Under direction, the ... the department on assigned hospital committees.Ensures cost-effective care through utilization management and care coordination.General Responsibilities:Performs other… more
- Centene Corporation (Oklahoma City, OK)
- … (UM) to align to goals and objectives + Develops, implements, and maintains compliance with BH utilization management policies and procedures + Reviews ... management . + Manages behavioral health (BH) utilization review clinicians and ensures compliance with...+ Licensed Mental Health Professional (LMHP) required or + RN - Registered Nurse -… more
- SSM Health (Midwest City, OK)
- …Illinois Department of Financial and Professional Regulation (IDFPR) State of Work Location: Missouri + Registered Nurse ( RN ) Issued by Compact State + Or + ... in standard work. + May also be responsible for: utilization management process, ED case management...Registered Nurse ( RN ) - Missouri Division of Professional… more
- SSM Health (Oklahoma City, OK)
- …Support HealthCare Provider (BLS HCP) - American Heart Association (AHA) + And + Registered Nurse ( RN ) - Missouri Division of Professional Registration + ... evaluation of outcomes. + Implements strategies to promote the utilization and compliance of the Donna Wright...Or + Registered Nurse ( RN ) Issued by… more
- Highmark Health (Oklahoma City, OK)
- …degree or RN diploma. **Preferred** + None **LICENSES or CERTIFICATIONS** **Required** + Registered Nurse ( RN ) license in PA; additional states may be ... member is responsible for building relationships, engaging clinicians, educating on Utilization Management policies and processes, developing workflows and… more
- CVS Health (Oklahoma City, OK)
- …established plan of care to meet the member's goals. + Utilizes care management processes in compliance with regulatory and company policies and procedures. ... as required by the State regulatory agency. Preferred Qualifications + Case management in an integrated model + Managed care/ utilization review experience… more
- SSM Health (Oklahoma City, OK)
- …years' experience, with seven years' in leadership **Required Professional License/Certifications** + Registered Nurse ( RN ) Issued by Compact State or ... ethical behavior in the areas of business ethics, legal compliance , confidentiality, conflicts of interest, vendor relationships and the... Registered Nurse ( RN ) - Oklahoma Board of Nursing… more
- CenterWell (Oklahoma City, OK)
- …payer contracts + Monitor the following key functions: + Program evaluation + Risk Management + Utilization Review + Patient Care Evaluation + Policies and ... patient care policy manuals. + Establish service policies and procedures in compliance with state health statutes and administrative rules, including CDC and OSHA… more
