Job Search

Job Title, Keywords, Req ID
Loading...
  • Tulsa, OK, USA ● Req #464
    Wednesday, February 28, 2024
    JOB SUMMARY: Responsible for clinical review of utilization requests and assessment and implementation of potential coordination of care opportunities for overall membership, institutionalized populations, high risk members, and other members identified with at risk or high utilization needs. Functions as an active team member of the Utilization Management Team. KEY RESPONSIBILITIES: Performs utilization review of outpatient and ancillary services as well as inpatient and post-acute services ... More
  • Tulsa, OK, USA ● Req #463
    Wednesday, February 28, 2024
    JOB SUMMARY: Responsible for clinical review of utilization requests and assessment and implementation of potential coordination of care opportunities for overall membership, institutionalized populations, high risk members, and other members identified with at risk or high utilization needs. Functions as an active team member of the Utilization Management Team.   KEY RESPONSIBILITIES: Performs utilization review of outpatient and ancillary services as well as inpatient and post-acute service ... More
  • Tulsa, OK, USA ● Req #466
    Wednesday, February 28, 2024
    JOB SUMMARY: This non-clinical position supports the department by performing a broad range of clerical duties.     KEY RESPONSIBILITIES: Prepares correspondence to members, providers, and facilities. Provides follow up with providers and members as needed. Reviews service requests for completeness of information. Enters information into the database, compiles data and runs reports. Receives telephone calls, answers non-clinical questions and takes information, or refers callers to appropriate ... More
  • Tulsa, OK, USA ● Req #469
    Tuesday, February 27, 2024
    JOB SUMMARY: The Managed Care Clinical Pharmacist will provide clinical pharmacy support to the CommunityCare Pharmacy Department including development of criteria for medications requiring a prior authorization, management of the drug utilization protocol, clinical support for the CMS Medication related STARs Measures, Medication Therapy Management (MTM) outreach, and other clinical duties as needed.  The ability to influence members and providers to act is important. This position will also wo ... More
  • Tulsa, OK, USA ● Req #451
    Sunday, February 25, 2024
    JOB SUMMARY:  Responsible for marketing the company’s commercial products to prospective clients and for assisting in the servicing and retaining existing accounts.   KEY RESPONSIBILITIES: Identifies and sells lines of business directly to potential corporate clients and through an assigned distribution of agents/brokers. Group market includes an emphasis on small and large group market. Must comply with provisions contained within the Sales Compensation Program.  Identifies new opportunities w ... More
  • Tulsa, OK, USA ● Req #457
    Sunday, February 25, 2024
    JOB SUMMARY: Responsible for conducting clinical behavioral health assessments and/or brief counseling of clients. Make referrals and conducts referral assessments, and follow-up. Provide training and/or workshops to EAP companies.   KEY RESPONSIBILITIES: Conducts clinical behavioral health assessments and/or brief counseling of clients and makes referrals to contracted providers for select diagnoses. Monitor and manage affiliate cases to insure appropriate utilization of the EAP.  Conducts ... More
  • Tulsa, OK, USA ● Req #331
    Saturday, February 24, 2024
      JOB SUMMARY: The Manager of Data Reporting and Report Development is responsible for architecting advanced data solutions while directing a team of data analysts in providing analytical, operational, cost and quality metrics to both internal and external customers, including regulatory reporting to CMS. This role acts as the Architect of data warehouse data marts and self-service reporting platform solutions. Additionally, this role supervises and manages both a team of health data analysts, ... More
  • Tulsa, OK, USA ● Req #332
    Saturday, February 24, 2024
    JOB SUMMARY: The Data Engineer II will be responsible for expanding and optimizing our data and data pipeline architecture, as well as optimizing data flow and collection across organizational teams. The Data Engineer will support our software engineers, database architects and data analysts on data initiatives and will ensure optimal data delivery architecture is consistent throughout ongoing projects. KEY RESPONSIBILITIES: •Create and maintain optimal data pipeline architecture to support o ... More
  • Tulsa, OK, USA ● Req #468
    Friday, February 23, 2024
    JOB SUMMARY: Responsible for the development and implementation of new computer applications in addition to maintaining and executing applications.    KEY RESPONSIBILITIES: Design, code and implement applications related to operations and system functions.  Maintain and update existing applications, processes and required system functions.  Perform special projects.  Train end-users as needed. Perform other duties as assigned.   QUALIFICATIONS: Ability to assess and prioritize issues an ... More
  • Tulsa, OK, USA ● Req #470
    Friday, February 23, 2024
    JOB SUMMARY: Responsible for completing out-bound calls and other member outreach opportunities to select members and documenting efforts.  This role spends 100% of time on quality program activities.  May require extended, or multiple, phone calls to members.  May require work on additional projects as directed.    KEY RESPONSIBILITIES: Contact members selected for intervention. Assist members with developing a plan to resolve identified HEDIS gaps in care, setting up appointments, getting t ... More
  • Tulsa, OK, USA ● Req #471
    Friday, February 23, 2024
    JOB SUMMARY: Responsible for completing out-bound calls and other member outreach opportunities to select members and documenting efforts.  This role spends 100% of time on quality program activities.  May require extended, or multiple, phone calls to members.  May require work on additional projects as directed.    KEY RESPONSIBILITIES: Contact members selected for intervention. Assist members with developing a plan to resolve identified HEDIS gaps in care, setting up appointments, getting t ... More
  • Tulsa, OK, USA ● Req #472
    Friday, February 23, 2024
    JOB SUMMARY: Responsible for monitoring and reviewing communication skills displayed by Customer Service Representatives to assure quality customer service skills and member satisfaction.    KEY RESPONSIBILITIES: Monitors the Customer Service lines and makes recommendations to improve the effectiveness of the individual representatives. Responsible for supporting performance guarantees by maintaining quality monitor audits, percentages of accuracy, and other data elements as required.  Provi ... More
  • Tulsa, OK, USA ● Req #473
    Friday, February 23, 2024
    JOB SUMMARY: Responsible for all aspects of enrollment and eligibility for all products. Develops and implementsprocedures to improve and minimize human error while increasing output and production. Trains personnel on government regulations, processes, and timelines related to processing eligibility. Keeps abreast of incoming changes in legislation and regulatory issues that impact the products enrollment process.     KEY RESPONSIBILITIES: Manages operations of enrollment activities includi ... More
  • Tulsa, OK, USA ● Req #474
    Friday, February 23, 2024
    JOB SUMMARY: Provide enterprise-wide system infrastructure support for complex system and interconnected technologies that require day-to-day support and administration to maintain optimum performance and utilization.   KEY RESPONSIBILITIES: Manage cloud implementations, upgrades, migrations, and change requests on cloud (Azure) environments Create, implement, and assist in the development of scripts to automate everyday operations Monitor and maintain multiple (DevOps) environments based on c ... More
  • Tulsa, OK, USA ● Req #465
    Wednesday, February 21, 2024
    Job Summary: Assists in the  preparation of monthly financial statements. Additional responsibilities include assisting with external audits and preparing monthly financial statement analysis as assigned. Assists with preparation of NAIC filings. Responsibilities: Assist in the coordination and preparation of the Company’s financial statements and reports for internal distribution and regulatory filings. Assist in preparation of Investment entries and assists with treasury responsibilities. Ass ... More
  • Tulsa, OK, USA ● Req #356
    Wednesday, February 21, 2024
    JOB SUMMARY: As the CRM Administrator for CommunityCare, you will develop and maintain the CRM systems. In this role, you will monitor end-user usage of the system, perform daily administrative and user support tasks, and help solve business problems. You will partner with product owners to define system requirements, and build, configure, and automate technology solutions to deliver business value. KEY RESPONSIBILITIES: Serve as a system administrator collaborating with the product owner, han ... More
  • Tulsa, OK, USA ● Req #204
    Tuesday, February 20, 2024
    JOB SUMMARY: The Sr. Software Engineer will build out the next generation of our platform. As a Sr. Software Engineer, you are expected to work independently, and within teams, leading the development of software features. Ability to prioritize well, communicate clearly, have a consistent track record of delivery, and excellent software engineering skills. You will be involved with mentoring other team members and helping with identifying process improvements for the team. KEY RESPONSIBILITIES:D ... More
  • Tulsa, OK, USA ● Req #390
    Saturday, February 17, 2024
    JOB SUMMARY: Responsible for leading and directing IT related projects from development through completion and ensuring successful output; outline the project goals and objectives, while acting as a liaison between the program staff, management and business groups. Manage status reporting, stability of assigned project-oriented work efforts, customer expectations for contracted time, cost, and requirements definitions. Provides a single point of contact for project assignments. Assembles proje ... More
  • Tulsa, OK, USA ● Req #448
    Thursday, February 15, 2024
    JOB SUMMARY: As a Software Engineering Intern, you will work closely with our experienced development team to design, implement, and maintain software solutions using C# on the Microsoft Azure cloud platform. This role provides a unique chance to contribute to the development of scalable and reliable applications that leverage the power of cloud computing.   KEY RESPONSIBILITIES: Software Development: Collaborate with the development team to design and implement software solutions using C# a ... More
  • Tulsa, OK, USA ● Req #397
    Thursday, February 15, 2024
    JOB SUMMARY: Responsible for being the first point of contact for all membership related questions, requests and concerns and for providing outstanding service to our customers. You will answer queries regarding customer benefits, eligibility, PCPs, claims and other questions. You will handle complaints, troubleshoot problems and provide resolutions in a professional and polite manner to ensure first contact resolution and customer satisfaction. The ideal Customer Service Representative will b ... More
  • Tulsa, OK, USA ● Req #399
    Thursday, February 15, 2024
    JOB SUMMARY: Responsible for being the first point of contact for all membership related questions, requests and concerns and for providing outstanding service to our customers. You will answer queries regarding customer benefits, eligibility, PCPs, claims and other questions. You will handle complaints, troubleshoot problems and provide resolutions in a professional and polite manner to ensure first contact resolution and customer satisfaction. The ideal Customer Service Representative will b ... More
  • Tulsa, OK, USA ● Req #400
    Thursday, February 15, 2024
    JOB SUMMARY: Controls, organizes and monitors the flow of printed materials. Accurately generates and distributes materials, and coordinates with other departments to ensure documentation is generated in a timely manner. KEY RESPONSIBILITIES: Schedules print jobs, confirms product specifications, arranges and adjusts documentation prior to printing. Monitors the quality and viability of the product specifications and ensures deadlines are met. Scans documents from requesting departments. Com ... More
  • Tulsa, OK, USA ● Req #446
    Sunday, February 11, 2024
    JOB SUMMARY: The Analyst provides analytical support for all departments, including analysis, pricing, capitation, network and provider specific reporting. Analytical support includes creating and executing beginner and intermediate level reports and programs and programming modifications to previously written reports. The Analyst will collaborate with key stakeholders and determine the needed result including any special specifications. The Analyst will work with several databases to pull and ... More
  • Tulsa, OK, USA ● Req #443
    Sunday, February 11, 2024
    JOB SUMMARY: Responsibilities include performing credentialing activities consistently for each applicant in accordance with federal and state mandates, and credentialing criteria as outlined in the CommunityCare Managed Healthcare Plans of Oklahoma Policy and Procedure Manual. KEY RESPONSIBILITIES: Responsible for initial assessment of applications and other data for accuracy and completeness and contacting applicants or other outside resources to resolve questions or to obtain missing info ... More
  • Tulsa, OK, USA ● Req #460
    Friday, February 9, 2024
    JOB SUMMARY: Develop and implement effective sales strategies for large and small group businesses through the state of Oklahoma by fostering a high-performance a “member centric” and “performance driven” culture to meet membership targets. Develop deep relationships with brokers, businesses and community leaders to generate leads. Manage the sales pipeline, sponsor and support local events, educate brokers, plan for Community Care’s expansion into new counties and facilitate the hand off of sol ... More