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  • Tulsa, OK, USA ● Req #495
    Thursday, April 4, 2024
    JOB SUMMARY: This position is a part of a team that provides support to our sales and retention reps in the form of data gathering, data entry and analysis, proposal and financial exhibit development, and coordinates with internal and external customers to install and renew employer group benefits.   KEY RESPONSIBILITIES: Monitor email and respond to Request for Proposals (RFPs):  Gather benefit information from a variety of sources, coordinates response, inputs data and maintains all appropria ... More
  • Tulsa, OK, USA ● Req #496
    Thursday, April 4, 2024
    JOB SUMMARY: This position is a part of a team that provides support to our sales and retention reps in the form of data gathering, data entry and analysis, proposal and financial exhibit development, and coordinates with internal and external customers to install and renew employer group benefits.   KEY RESPONSIBILITIES: Monitor email and respond to Request for Proposals (RFPs):  Gather benefit information from a variety of sources, coordinates response, inputs data and maintains all appropria ... More
  • Tulsa, OK, USA ● Req #499
    Thursday, April 4, 2024
    JOB SUMMARY: Responsible for selling Medicare products and Individual Health Plan products via telemarketing calls and person-to-person meetings, including seminars.   KEY RESPONSIBILITIES: Discuss products and benefits with eligible beneficiaries on a person to person basis in various settings. Makes outbound calls, as allowed, to prospects to answer questions and to schedule further sales follow up calls.  Conducts onboarding calls to new enrollees. Conducts disenrollment survey calls. Rece ... More
  • Tulsa, OK, USA ● Req #504
    Thursday, April 4, 2024
    JOB SUMMARY: Responsible for processing reports, reconciling transactions and updating the system. Create and maintain customer eligibility in the company database, generate customer correspondence for new packets, assemble and distribute customer handbooks and process notifications.   KEY RESPONSIBILITIES: Create and maintain customer eligibility in the database. Generate appropriate correspondence and ID cards.  Review and process files and reports. Mail customer notices and requests for ... More
  • Tulsa, OK, USA ● Req #498
    Thursday, April 4, 2024
    JOB SUMMARY: This position is a part of a team that provides support to our sales and retention reps in the form of data gathering, data entry and analysis, proposal and financial exhibit development, and coordinates with internal and external customers to install and renew employer group benefits.   KEY RESPONSIBILITIES: Monitor email and respond to Request for Proposals (RFPs):  Gather benefit information from a variety of sources, coordinates response, inputs data and maintains all appropria ... More
  • Tulsa, OK, USA ● Req #475
    Thursday, April 4, 2024
    JOB SUMMARY: Responsible for providing technical and customer service support for pharmacy benefits, processing prior authorizations according to CMS and State regulations, and resolving pharmacy related complaints.   KEY RESPONSIBILITIES: Telephone support for pharmacies and members related to pharmacy benefits for the HMO product. Provides resolution for various types of phone calls including, but not limited to referral, authorization, and step therapy protocols between physicians, pharmac ... More
  • Tulsa, OK, USA ● Req #497
    Tuesday, April 2, 2024
    JOB SUMMARY: Responsible for selling Medicare products and Individual Health Plan products via telemarketing calls and person-to-person meetings, including seminars.   KEY RESPONSIBILITIES: Discuss products and benefits with eligible beneficiaries on a person to person basis in various settings. Makes outbound calls, as allowed, to prospects to answer questions and to schedule further sales follow up calls.  Receives inbound calls from prospective enrollees, answer questions about company pr ... More
  • Tulsa, OK, USA ● Req #483
    Tuesday, April 2, 2024
    JOB SUMMARY: Responsible for the review, analysis, reporting and follow-up of risk adjustment and clinical coding functions to support the accurate representation of the member’s clinical health status as well as the accuracy of internal systems to support clinical decisions. This role works collaboratively with multiple internal departments as well as with external providers.   KEY RESPONSIBILITIES: Serve as clinical coding resource across the CommunityCare Health Network Division in suppor ... More
  • Tulsa, OK, USA ● Req #452
    Saturday, March 30, 2024
    JOB SUMMARY: Responsible for training of all non-exempt personnel in the Claims, Enrollment, and Customer Service departments on procedures, policies, and mode of operations. This will be done by directly delivering content, developing content for learning, arranging for specialists to deliver content and by measuring the progress of the new hire.  The trainer will also assist current employees with residual training needs or training on new processes, procedures or products.    KEY RESPONSIBIL ... More
  • Tulsa, OK, USA ● Req #457
    Tuesday, March 26, 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 #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 #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 #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 #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 #462
    Friday, February 9, 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 #450
    Thursday, January 11, 2024
    JOB SUMMARY: The Senior Financial Analyst will embrace a strong emphasis on financial modeling and management reporting. As a key member of our finance team, they will be responsible for developing, analyzing, and presenting financial models and reports that drive strategic decision-making across the organization. In addition, the Senior Financial Analyst will be responsible for extracting insights from complex financial data, developing sophisticated financial models, and providing strategic re ... More
  • Tulsa, OK, USA ● Req #433
    Thursday, January 4, 2024
    JOB SUMMARY: The IT Project Management Intern will play a crucial role in supporting our Health Plan's projects by assisting in the implementation and optimization of project management tools and methodologies, with a specific emphasis on agile practices. This internship offers a unique opportunity to gain hands-on experience in healthcare IT project management while contributing to the success of impactful initiatives.   KEY RESPONSIBILITIES: Tools Implementation and Optimization: Assist in t ... More
  • Tulsa, OK, USA ● Req #434
    Thursday, January 4, 2024
    JOB SUMMARY: The Data Engineering Intern will work closely with our experienced data engineering team to support the development, implementation, and optimization of data pipelines and systems. This role will contribute to the organization's ability to derive meaningful insights from healthcare data, ultimately improving the quality of care and services provided to our members.   KEY RESPONSIBILITIES: Data Pipeline Development: Collaborate with the data engineering team to design, develop, and ... More
  • Tulsa, OK, USA ● Req #421
    Thursday, December 14, 2023
    JOB SUMMARY:Responsible for understanding application functionality, documenting test cases based on requirements and acceptance criteria, and assisting in automating tests for those test cases. Able to collaborate with business, project, and development stakeholders to understand new and existing features and functionality. Document test results for automated and manual tests. The Quality Assurance Specialist is responsible for the development of automated testing methods for existing and new ... More
  • Tulsa, OK, USA ● Req #430
    Thursday, December 14, 2023
    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 #355
    Thursday, August 17, 2023
    JOB SUMMARY: Directs the Data Analytics and Reporting, Actuarial, and Underwriting activities of the Company, including product and bid filing activities. Directs the development and analysis of the financial budget, with particular emphasis on premiums, medical costs and provider reimbursement plans. Directs and manages the analysis of medical, pharmacy, and other claim costs and related expenses, including utilization and other trends affecting the company. Directs and manages the estimation ... More