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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: Responsible for performing health intake functions, directing members to services needed. KEY RESPONSIBILITIES: •Verifies member eligibility, line of business and network affiliations for members and providers. Determines if the call is clinical and requires transfer to a clinical staff person. Will inform callers, including members, facility personnel, physicians, or other health care professionals of the utilization requirements and procedures. •Makes initial referrals that ...Read more about Behavioral Health - Intake Specialist 150-1002More
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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
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Tulsa, OK, USA ● Req #536Wednesday, August 21, 2024JOB SUMMARY: As a Financial Analyst specializing in modeling and process improvement, you will play a critical role in enhancing financial performance and operational efficiency within the organization. Your primary responsibilities will revolve around financial modeling, analysis, and the implementation of process improvements to drive strategic decision-making and optimizebusiness processes. KEY RESPONSIBILITIES: Financial Modeling: Develop and maintaincomplex financial models to an ...Read more about Financial Planning & Analysis - Financial Analyst 127-2005More
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Tulsa, OK, USA ● Req #560Wednesday, August 21, 2024JOB SUMMARY: As a Senior Manager of Software Engineering at CommunityCare, you will play a pivotal role in leading and managing our software engineering teams to deliver innovative solutions that drive the success of our healthcare plan initiatives. You will be responsible for overseeing the development and maintenance of software applications that are critical to our internal operations and our external users. KEY RESPONSIBILITIES: Provide strong leadership and guidance to the software enginee ...Read more about Information Technology - Senior Manager Software Engineering 130-6000More
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Tulsa, OK, USA ● Req #523Wednesday, August 21, 2024JOB SUMMARY: To provide administrative and clerical support to ensure the efficient operation of the department. KEY RESPONSIBILITIES: •General clerical duties including copying, scanning and faxing. •Develops and maintains files and logs as related to department needs. •Prepares mailings, forms and correspondence. •Complies and provides information as related to department to appropriate personnel. •Performs other duties as assigned. QUALIFICATIONS: •Knowledge of relevant software application ...Read more about Mailroom - Clerical Support Specialist 138-1001More
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Tulsa, OK, USA ● Req #355Wednesday, August 21, 2024JOB 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 ...Read more about Accounting/Finance - Director Actuarial & AnalyticsMore
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JOB SUMMARY: The Senior Claims Examiner is responsible for examining claims that require review prior to being adjudicated. The examiner will use their resources, knowledge and decision-making acumen to determine the appropriate actions to pay, deny or adjust the claim. Examiners are expected to meet performance expectations in accuracy and efficiency. The Senior Claims Examiner will generally handle claims involving multiple lines of business or has been permanently assigned additional respo ...Read more about Claims HMO - Claims Examiner 140-1031More
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Tulsa, OK, USA ● Req #628Wednesday, August 14, 2024JOB 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 ...Read more about Individual Marketing - Health Plan Consultant 176-1008More
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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 135-2004More