Job Search
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Tulsa, OK, USA ● Req #632Thursday, September 5, 2024JOB 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 ...Read more about Customer Service - Customer Service Representative (M-F 9am-1pm/10am-2pm or Weekends) 105-1067More
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Tulsa, OK, USA ● Req #646Wednesday, September 4, 2024JOB SUMMARY: Responsible for providing daily guidance, instruction and training to inspire the team to perform at their optimum. Will work directly with Customer Service Supervisor to create a team that works efficiently together to maximize the team’s potential. Also responsible for interacting with members, providers and other internal customers to resolve elevated problems of a complex nature. May serve as a liaison between Customer Service and other departments. Assists Customer Service ...Read more about Customer Service - Customer Service Team Lead 105-1047More
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Tulsa, OK, USA ● Req #640Wednesday, September 4, 2024JOB SUMMARY: Responsible for maintaining and supporting the Help Desk and new systems including network installations, personal computers support and maintenance, and infrastructure development. KEY RESPONSIBILITIES: Maintain help desk. Perform network administration including the installation and configuration of new personal computers. Research new technologies and developmental tools and recommend their implementation. Provide support to users in the resolution of so ...Read more about Information Technology - Help Desk Analyst 130-1011More
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Tulsa, OK, USA ● Req #633Wednesday, September 4, 2024JOB 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 to ...Read more about Quality Improvement - Member Engagement Specialist 195-1008More
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Tulsa, OK, USA ● Req #636Wednesday, September 4, 2024JOB 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 ...Read more about Customer Service - Customer Service Representative 105-1064More
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Tulsa, OK, USA ● Req #631Wednesday, September 4, 2024JOB 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 ...Read more about Customer Service - Customer Service Representative (Part Time) 105-1068More
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Tulsa, OK, USA ● Req #599Thursday, August 29, 2024JOB SUMMARY: Responsible for performing general clerical functions, departmental customer service and support. KEY RESPONSIBILITIES: Provide clerical support to department including copies, filing, mailing or faxing as directed. Process all incoming departmental mail and documents. Responsible for file retention, relocation and shredding. Responsible for departmental document imaging, auditing and indexing of imaged files. Assist other departmental members as needed and phone back-up. Perfo ...Read more about Provider Services - Support Specialist 115-1020 (part time)More
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Tulsa, OK, USA ● Req #462Thursday, August 29, 2024JOB 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 ...Read more about Medical Management - Intake Coordinator 145-1013More
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Tulsa, OK, USA ● Req #504Wednesday, August 28, 2024JOB 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 ...Read more about Enrollment Services - Enrollment Specialist 160-1003More
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Tulsa, OK, USA ● Req #638Monday, August 26, 2024JOB SUMMARY: The Software Engineer will build out the next generation of our platform. As a Software Engineer, you are expected to work independently, and within teams, leading the development of software features. You will be involved with the early stages of mentoring other team members and helping with identifying process improvements for the team. KEY RESPONSIBILITIES: •Implements features of the application and is proficient in one or more of the feature or components. •Leads independent ...Read more about Information Technology - Software Engineer 130-2048More
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Tulsa, OK, USA ● Req #609Sunday, August 25, 2024JOB SUMMARY: The Stars Medication Adherence Specialist implements, tracks and supports new and existing healthcare quality improvement initiatives and education programs; ensures maintenance of programs for providers and members in accordance with prescribed quality standards; conducts data collection, tracking and monitoring for key performance measurement activities at the provider and member level. Provides ongoing practice support and sustains the partnership. Improves the understanding and ...Read more about Quality Improvement - STARS Medication Adherence Specialist 195-1031More
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Tulsa, OK, USA ● Req #600Sunday, August 25, 2024JOB 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 ...Read more about Pharmacy - Pharmacy Technical Support Specialist 146-1002More
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Tulsa, OK, USA ● Req #607Sunday, August 25, 2024JOB SUMMARY: Primarily responsible for contracting, orientation and ongoing education of physicians, physician office staffs, hospitals and other providers regarding the policies and procedures of CommunityCare Managed HealthCare Plans. Serves as the liaison between the provider community and the health plan. KEY RESPONSIBILITIES: Conducts educational and credentialing PCP and appropriate SCP office site visits according to established standards. Provides ongoing education, develops agendas, ...Read more about Provider Services - Provider Services Representative 115-1001More
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Tulsa, OK, USA ● Req #601Sunday, August 25, 2024JOB 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 servi ...Read more about Medical Management - Utilization Management RN 145-2022More
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JOB SUMMARY: The Stars Manager will oversee and drive the health plan to achieve optimal star ratings for Medicare and Marketplace related product lines. The Stars Manager will assist in developing strategy and translate strategy and goals into execution within a matrixed organizational environment. Overall percentage of responsibilities pertaining to quality activities for this job role is 100%. KEY RESPONSIBILITIES: Work across the health plan and with provider leadership to develop an ...Read more about Quality Improvement - Manager STARS 195-5003More
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Tulsa, OK, USA ● Req #593Wednesday, August 21, 2024JOB 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 ...Read more about Customer Service - Customer Service Representative 105-1033More
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JOB SUMMARY: Responsible for training of all non-exempt personnel in the Claims department 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 RESPONSIBILITIES: • Represent the company in a posi ...Read more about Claims HMO - Trainer 140-1020More
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Tulsa, OK, USA ● Req #579Wednesday, August 21, 2024JOB SUMMARY: Responsible for overseeing Care Management and Utilization Management segments of the health care delivery area. This key Executive role provides leadership to a large team of nurses, coordinators, and other personnel to determine approvals/denials of claims as well as direction to several important initiatives as requested. The Senior Medical Director has current, relevant knowledge and/or has current, relevant clinical expertise to manage cases under review, including the current, ...Read more about Medical Management - Senior Medical Director 145-8000More
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JOB SUMMARY: Member Advocate II will provide exceptional service to our members that require customer service assistance in person at our Senior Center. Generally, the Member Advocate is called upon to listen to members, empathize with them and then work to solve issues they are unable to solve on their own regarding their health insurance or healthcare. The Advocates are called on to handle the more complex problems faced by our members or that may be reported to us by our various regulatory ...Read more about Senior Center - Member Advocate II 171-1007More
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Tulsa, OK, USA ● Req #578Wednesday, August 21, 2024JOB SUMMARY: Primarily responsible for contracting, orientation and ongoing education of physicians, physician office staffs, hospitals and other providers regarding the policies and procedures of CommunityCare Managed HealthCare Plans. Serves as the liaison between the provider community and the health plan. KEY RESPONSIBILITIES: Conducts educational and credentialing PCP and appropriate SCP office site visits according to established standards. Provides ongoing education, develops agendas, ...Read more about Provider Services - Provider Services Representative 115-1005More
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Tulsa, OK, USA ● Req #575Wednesday, August 21, 2024JOB SUMMARY: The Senior Health Data Analyst provides the analytical support for Executives and all departments including analysis, pricing, capitation, network, and provider specific reporting. Analytical support includes programming customer-based specifications, producing appropriate statistics, reports, and presentations, analyzing results and impacts, and generating written reports with recommendations and conclusions. The Senior Analyst works with data in company and other databases, data ...Read more about Reporting - Senior Health Data Analyst 135-2031More
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Tulsa, OK, USA ● Req #576Wednesday, August 21, 2024JOB SUMMARY: The Senior Health Data Analyst provides the analytical support for Executives and all departments including analysis, pricing, capitation, network, and provider specific reporting. Analytical support includes programming customer-based specifications, producing appropriate statistics, reports, and presentations, analyzing results and impacts, and generating written reports with recommendations and conclusions. The Senior Analyst works with data in company and other databases, data ...Read more about Reporting - Senior Health Data Analyst 135-2030More
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Tulsa, OK, USA ● Req #457Wednesday, August 21, 2024JOB 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 ...Read more about Employee Assistance Program - EAP Counselor 151-2004More
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Tulsa, OK, USA ● Req #513Wednesday, August 21, 2024JOB 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 ...Read more about Medical Management - Intake Coordinator 145-1021More
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JOB SUMMARY: The Analyst II provides analytical support for all departments, including analysis, pricing, capitation, network and provider specific reporting. Analytical support includes creating and executing intermediate to advanced level reports and programs and programming modifications to previously written reports. The Analyst II will collaborate with key stakeholders and determine the needed result including any special specifications. The Analyst II will work with several databases to p ...Read more about Reporting - Health Data Analyst II 135-2009More