• 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 ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
    Humana (01/09/26)
    - Save Job - Related Jobs - Block Source
  • SNF Utilization Management RN…

    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 ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
    Humana (12/12/25)
    - Save Job - Related Jobs - Block Source
  • Pre-Authorization Nurse

    Humana (Oklahoma City, OK)
    …skills to make an impact** **Required Qualifications** + **Must Reside in Oklahoma** + Registered Nurse , licensed in Oklahoma without restrictions + 3+ years of ... + Previous Medicare/Medicaid experience a plus + Previous experience in pre-authorization, utilization management , case management , discharge planning and/or… more
    Humana (01/06/26)
    - Save Job - Related Jobs - Block Source
  • Pre-Authorization Nurse

    Humana (Oklahoma City, OK)
    …We are not able to hire candidates that are currently living in Puerto Rico. + Registered Nurse with current in-state RN license + At least 3 years of varied ... or comparable (such as Interqual, etc.) ​ **Preferred Qualifications** + Utilization Review/Quality Management experience + BA/BSN degree **Work-At-Home… more
    Humana (01/07/26)
    - Save Job - Related Jobs - Block Source
  • Clinical Reviewer, Nurse (Medical Oncology)

    Evolent (Oklahoma City, OK)
    …+ Performs other duties as assigned. **The Experience You'll Need (Required):** + Registered Nurse or Licensed Practical/Vocational Nurse with a current, ... Stay for the culture. **What You'll Be Doing:** The Clinical Review Nurse is responsible for performing precertification and prior approvals. Tasks are performed… more
    Evolent (12/10/25)
    - Save Job - Related Jobs - Block Source
  • RN - Inpatient Wound Care Nurse

    SSM Health (Midwest City, OK)
    …Basic Life Support HealthCare Provider (BLS HCP) - American Heart Association (AHA) + And + Registered Nurse (RN) Issued by Compact State + Or + Registered ... and communicates with patient/family/caregiver and appropriate nursing, physician, and care management staff. + Utilizes research and other forms of evidence to… more
    SSM Health (12/13/25)
    - Save Job - Related Jobs - Block Source
  • RN-Wound (H)

    SSM Health (Oklahoma City, OK)
    …Support HealthCare Provider (BLS HCP) - American Heart Association (AHA) + And + Registered Nurse (RN) - Missouri Division of Professional Registration + Or + ... communicates with patient/family/caregiver and appropriate nursing, physician, and care management staff. + Utilizes research and other forms of... Registered Nurse (RN) Issued by Compact State… more
    SSM Health (12/11/25)
    - Save Job - Related Jobs - Block Source
  • Payment Integrity Clinician

    Highmark Health (Oklahoma City, OK)
    …and education or if necessary involve Special Investigation Unit or the Utilization Management area. **ESSENTIAL RESPONSIBILITIES** + Implement the pre-payment ... data to assure appropriate level of payment and resource utilization . It is also used to identify issues which...experience in Managed Care **LICENSES or CERTIFICATIONS** **Required** + Registered Nurse **Preferred** + Certified Medical Coder… more
    Highmark Health (11/14/25)
    - Save Job - Related Jobs - Block Source