• RN Utilization Management

    Humana (Oklahoma City, OK)
    …part of our caring community and help us put health first** The Utilization Management Behavioral Health Nurse uses behavioral health knowledge and ... licensed in a Compact State** The Utilization Management Behavioral Health Nurse completes...Qualifications** + Minimum of Associate Degree in Nursing + Registered Nurse ( RN ) licensure with… more
    Humana (10/04/24)
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  • Lead Director Quality Management

    CVS Health (Oklahoma City, OK)
    …expense reimbursement policy. Preferred Qualifications : Oklahoma residency preferred Oklahoma-licensed registered nurse preferred OR be certified as a Certified ... a variety of external and internal audiences including senior management . Required Qualifications : * 5 to 7 years'...(CHCQM) by the American Board of Quality Assurance and Utilization Review Providers prior to employment. A minimum of… more
    CVS Health (09/26/24)
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  • 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 (09/27/24)
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