- US Tech Solutions (May, OK)
- …Responsible for the review and evaluation of clinical information and documentation. Reviews documentation and interprets data obtained from clinical records or ... systems to apply appropriate clinical criteria and policies in line with regulatory and accreditation requirements for member and/or provider issues. Independently coordinates the clinical resolution with internal/external clinician support as required.… more
- Elara Caring (Buffalo, OK)
- …**Pay** **:** **$** **13** **.50/hr** Join our Elara Caring family and become a superhero of care! We're on a mission to keep people in their homes safely, one client ... at a time. Why Choose Elara Caring? + We've got an awesome team environment where everyone supports each other. + Daily Pay Available! Work today, get paid tomorrow. + Need a flexible schedule? We've got you covered. + Paid travel time between assignments Yes,… more
- US Tech Solutions (May, OK)
- …+ Responsible for reviewing and completing criteria based on prior authorization as per policy and procedure. **Responsibilities:** + This individual must have ... excellent interpersonal skills. + Will be responsible for: Reviewing and completing criteria based on prior authorization as per policy and procedure. **Experience:** + Prior authorization experience required. + Previous pharmacy experience in retail or… more
- Paychex (May, OK)
- …+ Develops and executes a structured prospecting plan targeting the 7,000+ US financial institutions in order to develop new referral relationships and increase sales ... volume from the channel. + Drives Field Sales execution of the company's bank referral partnerships to increase channel productivity by: - Developing and then working with Sales Management to implement standard bank calling routines for sales reps. -… more
- US Tech Solutions (May, OK)
- …+ It is an operation based role that conducts clinical reviews of medical data collected to perform prior authorization for specialty medications. The clinical ... pharmacist will apply clinical knowledge to plan approved criteria for prospective and concurrent reviews of cases. **Responsibilities:** + Collaborates with the CRU Technician to process referrals, including answering clinical questions, collecting… more
- US Tech Solutions (May, OK)
- …Training will be provided prior to the start of the assignment. **Duties:** * Outreach to members to complete survey to address Social Determinants of Health (SDoH) ... barriers and provide helpful resources * Outreach to members and clinical providers to effectively coordinate care, obtain medical records and ensure patients receive preventive and chronic disease management services. The goal of these messages is to remind… more
- US Tech Solutions (May, OK)
- …1. Patient-Centered Quality and Safety * Evaluate primary care, acute, chronically ill, and transitional care patients, in addition to providing healthcare education ... and counseling, and disposition planning for our patients ranging in age 18 months and above * Provide patient counseling; inclusive of pregnancy prevention, STI Prevention/safer sex practices, contraceptive care counseling and medication management * Educate… more
- Love's Travel Stops & Country Stores (Buffalo, OK)
- **Req ID:** 449599 **Address:** Hwy 64 & Brule Buffalo, OK, 73834 **Benefits:** _* Fuel Your Growth with Love's - company funded tuition assistance program * Paid ... Time Off * Flexible Scheduling * 401(k) - 100% Match up to 5% * Medical/Dental/Vision Insurance after 30 days * Competitive Pay * Career Development * Hiring Immediately_ **Welcome to Love's!** At Love's, our cashiers work in a fast-paced environment and… more
- US Tech Solutions (May, OK)
- …Nurse Practitioner leverages administrative support in addition to delivering patient care services through virtual technology. The ratio of work is dependent upon ... patient demand. You will work in collaboration with a dedicated team of professionals as you independently provide holistic, evidenced-based care inclusive of accurate assessment, diagnosis, treatment, management of health problems, health counseling, and… more
- US Tech Solutions (May, OK)
- …. Participates in the development and ongoing implementation of QM Work Plan activities. . Improve quality products and services, by using measurement and analysis to ... process, evaluate and make recommendations to meet QM objectives Responsibilities: . Reviews documentation and evaluates Potential Quality of Care issues based on clinical policies and benefit determinations. . Considers all documented system information as… more
- US Tech Solutions (May, OK)
- …+ As an RPh Advisor you will be directly supporting Medicare Part D members and providers with requests related to their pharmacy benefits. You will be responsible ... for ensuring cases are accurately set up for our members, review clinical information for decisioning the request, performing outreach to providers for more information when needed, and ensuring accurate decisions that comply with compendia and Medicare… more
- US Tech Solutions (May, OK)
- …The Rep I, Clinical Services takes in-bound calls from providers, pharmacies, members, etc providing professional and courteous phone assistance to all callers ... through the criteria based prior authorization process. Maintains complete, timely and accurate documentation of reviews. Transfers all clinical questions, escalations and judgement calls to the pharmacist team. The Rep I, Clinical Services will also assist… more
- US Tech Solutions (May, OK)
- …+ The Tech I Prior Auth takes in-bound calls from providers, pharmacies, members, etc providing professional and courteous phone assistance to all callers through the ... criteria based prior authorization process. Maintains complete, timely and accurate documentation of reviews. Transfers all clinical questions, escalations and judgement calls to the pharmacist team. **Responsibilities:** + The Tech I will also assist with… more
- US Tech Solutions (May, OK)
- …+ Prior Authorization Specialist takes in-bound calls from providers, pharmacies, members, etc providing professional and courteous phone assistance to all callers ... through the criteria based prior authorization process. + Maintains complete, timely and accurate documentation of reviews. + Transfers all clinical questions, escalations and judgement calls to the pharmacist team. + The Rep I, Clinical Services will also… more
- US Tech Solutions (May, OK)
- …This is a remote position and requires the ability to effectively support a work from home environment. Must have the ability to work in a HIPAA compliant work area ... away from distractions, and must have their own secure private internet services of at least 25mbps download/3mbps upload in order to ensure sufficient speed to adequately perform work duties. Must provide a screenshot of internet speeds with resume and… more
- US Tech Solutions (May, OK)
- …The Rep I, Clinical Services takes in-bound calls from providers, pharmacies, members, etc providing professional and courteous phone assistance to all callers ... through the criteria based prior authorization process. Maintains complete, timely and accurate documentation of reviews. Transfers all clinical questions, escalations and judgement calls to the pharmacist team. The Rep I, Clinical Services will also assist… more
- US Tech Solutions (May, OK)
- …+ This position is responsible for reviewing and completing criteria based on prior authorization as per policy and procedure. **Responsibilities:** + Reviewing and ... completing criteria based on prior authorization as per policy and procedure. **Experience:** + Previous pharmacy experience in PBM (Pharmacy Benefits Management) required. + Since the job duties consist of reviewing and completing criteria based on prior… more
- US Tech Solutions (May, OK)
- …The Tech I Prior Auth takes in-bound calls from providers, pharmacies, members, etc providing professional and courteous phone assistance to all callers through the ... criteria based prior authorization process. Maintains complete, timely and accurate documentation of reviews. Transfers all clinical questions, escalations and judgement calls to the pharmacist team. The Tech I will also assist with other duties as needed to… more
- US Tech Solutions (May, OK)
- …This position interprets relevant clinical criteria through review of medical records, annotates via Adobe PDF and populates a data collection tool to support ... compliance with HEDIS and CMS performance measures. Ensures accurate and complete documentation of required information to meet risk management, regulatory, and accreditation requirements. The candidate must be proficient with databases and with conducting… more
- US Tech Solutions (May, OK)
- …This position involves receiving in-coming calls from members, providers, etc., and providing professional phone assistance through the criteria-based prior ... authorization process. The role requires maintaining complete, timely, and accurate documentation of all approvals and denials, and transferring all clinical questions and judgment calls to the pharmacist. **Duties:** + At least 1 year experience as a pharmacy… more