Top 38 Utilization review Jobs in Norman, Ok

Health Services Coordinator
GLOBALHEALTH HOLDINGS LLC —Oklahoma City, OK
- Full-time
- Remote
- Microsoft Word
- Microsoft Excel
- HIPAA
- Health insurance
Quick Apply
5d
Utilization Management Coordinator-Pre-Arrival
Saint Francis Hospital, Inc. —Oklahoma City, OK
- Part-time
- Microsoft Word
- LMFT
- Nursing
Quick Apply
12h
Senior Review Coordinator (Oncology) - Utilization Management (RN)
Telligen —Oklahoma City, OK
- Email
- Hybrid work
- Nursing
- RN License
- Research
Quick Apply
Case Manager (SW / RN) PRN
SSM Health Rehabilitation Hospital – Oklahoma City —Oklahoma City, OK
- $40 an hour
- Weekends as needed
- Hospital
- Inpatient
- Mid-level
- Opportunities for advancement
Quick Apply
Clinical Director (LBHP) for Detox
Pathways Recovery Centers —Oklahoma City, OK
- From $75,000 a year
- Full-time
- Hybrid work
- Background check
- LMFT
- Licensed Clinical Social Worker
Quick Apply
Registered Nurse - Case Manager
SSM Health —Oklahoma City, OK
- Full-time
- Nursing
- RN License
- Mid-level
- Paid parental leave
- Health insurance
7d
Registered Nurse - Case Manager
SSM Health —Oklahoma City, OK
- Part-time
- Nursing
- RN License
- Mid-level
- Paid parental leave
- Health insurance
7d
RN Manager - Baptist Case Management
INTEGRIS Health —Oklahoma
- Full-time
- Nursing
- RN License
- Hospital
- Health insurance
- Paid time off
Quick Apply
Clinical Outreach Liaison
Thousand Branches Wellness —Oklahoma City, OK
- Weekends as needed
- Mid-level
- Residential
- Master's degree
- Health savings account
- Disability insurance
Quick Apply
RN Case Manager - Baptist
INTEGRIS Health —Oklahoma
- Full-time
- Nursing
- RN License
- Hospital
- Health insurance
- Paid time off
Quick Apply
Case Manager / PRN - Social Worker
Select Specialty Hospital - Oklahoma City —Oklahoma City, OK
- Part-time
- Mid-level
- Critical & Intensive Care
- Social Work
- Employee assistance program
- Opportunities for advancement
Quick Apply
Part-time RN Nurse Navigator - Meinders Center for Movement Disorders
Mercy —Oklahoma City, OK
- Part-time
- Nursing
- RN License
- Hospital
- Health insurance
- Dental insurance
RN Care Manager - South Case Management - Part Time
INTEGRIS Health —Oklahoma City, OK
- Part-time
- Nursing
- Patient monitoring
- Addiction Medicine
- Health insurance
- Paid time off
Quick Apply
RN-Community Care Coordinator, Nursing Operations
US Veterans Health Administration —Oklahoma City, OK
- $75,016 - $139,502 a year
- Online Application
- Background check
- Nursing
- Doctoral degree
- Paid holidays
- Dental insurance
Complex Care Manager - Readmissions
OU Health —Oklahoma City, OK
- Full-time
- Nursing
- RN License
- Hospital
- Relocation assistance
- Health insurance
Adon/Case Mng
The Wilshire Skilled Nursing & Therapy —Oklahoma City, OK
- Full-time
- CPR Certification
- Nursing
- Skilled nursing facility
- Health insurance
- Dental insurance
Quick Apply
13d
Program Manager- IOP
Thousand Branches Wellness —Oklahoma City, OK
- Full-time
- LMFT
- 5 years
- Licensed Clinical Social Worker
- Health savings account
- Disability insurance
5d
Registered Nurse (RN) - House Supervisor - Nights
Norman Regional Health System —Norman, OK
- $36.36 - $59.83 an hour
- Full-time
- Nursing
- RN License
- Bachelor of Science
- Free parking
- Paid holidays
Registered Nurse (Weekend Supervisor
Midwest City Post Acute & Rehab —Oklahoma City, OK
- $38 - $42 an hour
- Part-time
- Nursing
- Patient monitoring
- RN License
Quick Apply
5d
RN Case Manager - South Case Management
INTEGRIS Health —Oklahoma City, OK
- Full-time
- Nursing
- RN License
- Hospital
- Health insurance
- Paid time off
Quick Apply
7d

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Health Services Coordinator

GLOBALHEALTH HOLDINGS LLC -
Oklahoma City, OK

Quick Apply

Job Details

Full-time
5 days ago

Benefits

Health insurance

Qualifications

Customer communication
Administrative experience
High school diploma or GED
Data entry

Full Job Description

WHO WE ARE:

GlobalHealth is a fast-growing Medicare Advantage HMO health insurer. We aspire to be the employer of choice in our industry, attracting and retaining a highly talented workforce. Our passion is Genuine Care and Optimal Health for the members we serve. We are unique by providing high touch, high value and a partnership to our members. We go above and beyond to provide personalized, engaging, and responsive services to our members. We work hard to offer affordable health insurance coverage with the benefits people truly want and need. It is our hope to be more than just a health insurance company we want to be long-term partners with our members. We are looking for future employees who exude our core values of taking accountability through ownership, being driven, innovative and who have a passion for continuous learning.

WHO YOU ARE:

This position, under the direction of the Supervisor, Heath Services Coordination, provides administrative support for utilization review, health education and care management. This includes data entry, communication with members, providers, and vendors for education and information gathering.

ESSENTIAL JOB FUNCTIONS:

Following Medicare/Medicaid Timelines for Notification to Provider/Members to meet department goals and requirements.
Verbal and/or written outreach to members and/or providers to provide updates on referral request status, reasoning behind decisions, and provide accurate information.
Daily Mail fulfillment – faxes to provide notification to provider or member of decisions,
Coordination of services for members, including community resources and collaboration with assigned case manager
Develop and maintain resources related to the department.
Support departmental initiatives.
Identify and report process improvement opportunities.
Manage and document member and provider calls.
Enter authorization requests in the medical management systems.
Process member notifications
Must maintain confidentiality of business information, including Protected Health Information (PHI), as required by HIPAA and company policy.
Performs other duties as assigned.

EDUCATION AND EXPERIENCE:

High School diploma or equivalent and two years of data entry experience in an administrative support position required.
Experience working with medical records preferred.
Experience working in managed care or utilization management environment preferred.

KNOWLEDGE, SKILLS AND ABILITIES:

Strong attention to detail
Excellent communication skills, Clear and effective written and verbal
Organization and time management skills, including ability to prioritize tasks.
Strong working knowledge of Microsoft Word, Visio, Excel and Power Point.
Strategic and Analytic thinking, Lean Six Sigma Green belt or Black belt- preferred.
Ability to work independently and with a group.
Self-motivated
Excellent customer service skills
Demonstrated knowledge of managing the use of a SharePoint site or equivalent application

WORK ENVIRONMENT:

Current work environment is remote; however, some state exclusions apply. Must have access to a reliable and secured internet connection source. Work environment must maintain confidentiality of business information, including Protected Health Information (PHI), as required by HIPAA and company policy. This position will also be required to use reasonable and necessary safeguards to protect GlobalHealth records from unauthorized access, disclosure or damage and will adhere to all GlobalHealth privacy and security policies.

TRAVEL:

N/A

SUPERVISORY RESPONSIBILITY:

N/A

OTHER DUTIES:

This job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.

Quick Apply

Refine Your Search

utilization review jobs in norman, ok

Health Services Coordinator

Utilization Management Coordinator-Pre-Arrival

Senior Review Coordinator (Oncology) - Utilization Management (RN)

Case Manager (SW / RN) PRN

Clinical Director (LBHP) for Detox

Registered Nurse - Case Manager

Registered Nurse - Case Manager

RN Manager - Baptist Case Management

Clinical Outreach Liaison

RN Case Manager - Baptist

Case Manager / PRN - Social Worker

Part-time RN Nurse Navigator - Meinders Center for Movement Disorders

RN Care Manager - South Case Management - Part Time

RN-Community Care Coordinator, Nursing Operations

Complex Care Manager - Readmissions

Adon/Case Mng

Program Manager- IOP

Registered Nurse (RN) - House Supervisor - Nights

Registered Nurse (Weekend Supervisor

RN Case Manager - South Case Management

I want to receive the latest job alert for utilization review in norman, ok

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