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Sunbeam Family Services Remote jobs - 181 jobs

  • Consumer Services Representative

    Ocean Dental 3.3company rating

    Edmond, OK jobs

    We are seeking a customer-focused and detail-oriented Consumer Services Representative to join our team in a fully remote capacity. The ideal candidate will be responsible for assisting customers with inquiries, resolving issues, providing product or service information, and ensuring a positive customer experience across multiple communication channels. Key Responsibilities Respond to customer inquiries via phone, email, chat, or messaging platform. Provide accurate information about products, services, policies, and procedures. Resolve customer issues efficiently while maintaining professionalism and empathy. Document all customer interactions in the CRM system. Process orders, returns, refunds, and account updates as needed. Escalate complex issues to the appropriate department or supervisor. Meet performance metrics such as response time, customer satisfaction, and quality standards. Stay informed about product updates, feature changes, and company policies. Contribute to a positive team environment and suggest process improvements. Qualifications High school diploma or equivalent (Associates or Bachelors degree a plus). Prior customer service experience preferred (call center, retail, hospitality, or similar). Strong written and verbal communication skills. Ability to work independently in a remote environment with minimal supervision. Comfortable using customer support software, CRM systems, and communication tools. Strong problem-solving and multitasking abilities. Reliable high-speed internet and a quiet workspace. Key Skills Customer service & communication Active listening Conflict resolution Multitasking & time management Tech-savviness Attention to detail Empathy & patience Work Environment 100% remote position Flexible or set schedule depending on role Requires consistent internet connection and adequate home office setup Benefits (Optional Section) Health, dental, and vision insurance Paid time off & holidays Retirement savings plan Performance bonuses Remote work stipend Preferred qualifications: Legally authorized to work in the United States 18 years or older
    $24k-28k yearly est. 37d ago
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  • Oxygen Delivery Technician

    Viemed Careers 3.8company rating

    Oklahoma City, OK jobs

    Essential Duties and Responsibilities Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of this position. Reports directly to the Oxygen Delivery Manager. Become familiar with all DOT and FDA regulations as they pertain to oxygen. Delivers equipment and supplies from inventory as prescribed on patient/client delivery tickets. Assures proper segregation of clean and dirty equipment in the delivery vehicle. Loads the equipment, oxygen systems, and related supplies into vehicle. Determines or obtains the best daily route, then drives delivery vehicles on that route, to deliver home medical equipment, oxygen, and supplies to home care patients/clients in a timely manner. Completes route sheet accurately and returns in a timely manner. Provides patient/client orientation, instructing on the proper use, maintenance, and safety of equipment. Works with patients/clients to solve a variety of problems, thereby acting as a company field representative. Returns and unloads returned rental equipment, assuring proper segregation of clean and dirty equipment. Completes delivery and pick-up paperwork promptly and accurately, including route sheets, manifests, and patient/client documentation, returning paperwork to the appropriate facility personnel. Assists in cleaning and disinfecting rental equipment. Assists in minor repair work on home medical equipment within the scope of training. Requests additional stock for inventory as needed. Assists in inventory count as needed. Maintains a professional appearance and appears in proper company uniform. Assists in tracking down paperwork, signatures, charts, etc. as needed to complete orders. Promotes teamwork among co-workers, including in assisting respiratory therapists and patient care coordinator as needed. Takes "on-call" time on an agreed upon basis. Performs all office maintenance tasks as required. Demonstrates timeliness, courtesy, sincerity, and patience when dealing with patients/clients. Markets the company in a positive and professional manner at all times. Assumes other duties within scope of training as assigned by the Respiratory Operations Manager. Other duties as assigned. Qualifications: High School Diploma preferred. 1-3 years of EMT and/or Medical Delivery Driver experience preferred. Excellent communication skills, both written and verbal to interact knowledgeably with customers/clients. Physical Demands: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. EE must frequently lift and/or move up to 10 pounds. EE must occasionally lift and/or move up to 50 pounds. Work Environment: This job will require the employee to go into patient homes and hospitals for the set-up and service of medical devices. Skills: Problem Solving/Analysis Time Management Communication Proficiency Technological Capability Customer/Client Focus Collaboration You will be expected to work Monday through Friday, 8:00 a.m. to 5:00 p.m. Please note this job description is not designed to cover and/or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties and responsibilities may change at any time with or without notice.
    $46k-58k yearly est. 8d ago
  • Temporary Organizational Readiness Specialist

    Ascension Health 3.3company rating

    Tulsa, OK jobs

    Details * Department: Change Enablement & Organizational Readiness * Schedule: Monday - Friday, Days, flexibility required closer to implementation (evenings/weekends) * Location: Will support Ascension facilities within the Tulsa, Oklahoma area. Travel will be required to sites in those areas (up to 75%). Opportunity for more remote work prior to go-live. * Temporary position with potential to end December 2026 Benefits Paid time off (PTO) Various health insurance options & wellness plans Retirement benefits including employer match plans Long-term & short-term disability Employee assistance programs (EAP) Parental leave & adoption assistance Tuition reimbursement Ways to give back to your community Benefit options and eligibility vary by position. Compensation varies based on factors including, but not limited to, experience, skills, education, performance, location and salary range at the time of the offer. Responsibilities The Organizational Readiness Specialist serves as the critical liaison between system office strategy and local market execution. The system office defines the Organizational Readiness strategy, the specialist ensures the strategy is understood, adopted, and successfully implemented within each market by translating Ministry-level decisions into market-specific readiness actions. This includes assessing local impacts, preparing stakeholders, coordinating communications and training, and ensuring effective implementation across the market(s). * Leads stakeholder engagement and conducts change impact assessments to understand and address readiness needs in local markets to serve as a connector with Ministry-driven changes. * Reinforces system office communication strategies to ensure clarity, alignment, and awareness across impacted groups. * Converts system office training plans, materials, and delivery to enable successful adoption of new systems or processes. * Provides hypercare and floor support during rollout to guide end users and resolve issues quickly. * Facilitates alignment between system office, change leaders, and local teams to ensure feedback flows both ways and deployment is consistent, effective, and timely. Requirements Education: * High School diploma equivalency with 2 years of cumulative experience OR Associate's degree/Bachelor's degree OR 4 years of applicable cumulative job specific experience required. Additional Preferences Additional Preferences: * 2-5 years+ of change management experience is strongly preferred. * 2-5 years of human resources and oracle experience is strongly preferred. * Experience working with varying levels of leadership across a large, matrix organization. * Strong communication skills. * Knowledge of training and implementations Why Join Our Team Ascension associates are key to our commitment of transforming healthcare and providing care to all, especially those most in need. Join us and help us drive impact through reimagining how we can deliver a people-centered healthcare experience and creating the solutions to do it. Explore career opportunities across our ministry locations and within our corporate headquarters. Ascension is a leading non-profit, faith-based national health system made up of over 134,000 associates and 2,600 sites of care, including more than 140 hospitals and 40 senior living communities in 19 states. Our Mission, Vision and Values encompass everything we do at Ascension. Every associate is empowered to give back, volunteer and make a positive impact in their community. Ascension careers are more than jobs; they are opportunities to enhance your life and the lives of the people around you. Equal Employment Opportunity Employer Ascension provides Equal Employment Opportunities (EEO) to all associates and applicants for employment without regard to race, color, religion, sex/gender, sexual orientation, gender identity or expression, pregnancy, childbirth, and related medical conditions, lactation, breastfeeding, national origin, citizenship, age, disability, genetic information, veteran status, marital status, all as defined by applicable law, and any other legally protected status or characteristic in accordance with applicable federal, state and local laws. For further information, view the EEO Know Your Rights (English) poster or EEO Know Your Rights (Spanish) poster. As a military friendly organization, Ascension promotes career flexibility and offers many benefits to help support the well-being of our military families, spouses, veterans and reservists. Our associates are empowered to apply their military experience and unique perspective to their civilian career with Ascension. Please note that Ascension will make an offer of employment only to individuals who have applied for a position using our official application. Be on alert for possible fraudulent offers of employment. Ascension will not solicit money or banking information from applicants. E-Verify Statement This employer participates in the Electronic Employment Verification Program. Please click the E-Verify link below for more information. E-Verify
    $38k-64k yearly est. Auto-Apply 6d ago
  • District Manager

    Biote 4.4company rating

    Tulsa, OK jobs

    Description Biote Medical is the world leader in hormone optimization and we are adding to our team! We partner with providers to take a complete approach to healthier aging through patient-specific bioidentical hormone replacement therapy and the only nutraceutical line created specifically to support hormone health.This position will help support our Tulsa territory. We're looking for someone with a passion for changing healthcare who wants to be in a hands-on and engaged position working within a dynamic and collaborative sales team.You must be located in the Tulsa area to be considered.Position and Scope:We are looking for a driven candidate with the desire to recruit qualified physicians and practitioners into a partnership relationship with Biote; in order to provide cutting edge technology for bioidentical hormone replacement therapy (BHRT) and healthy aging options to their own patients and to the public at large. The ideal candidate is responsible for relationship development, practice development and sales of the Biote Method to practitioners. Sales activity includes prospecting, cold calling, practice development, tradeshows, sales events, and other methods for creating leads and closing sales for Biote within the approved price matrix. In addition, the Liaison provides technical, educational, and Provider Partner support. This is a field-based remote position.As a District Manager, your daily responsibilities will include: Acquiring and retaining extensive knowledge of hormone replacement therapy through materials provided by Biote, as well as outside sources. Effectively conducting physician, staff and patient training in the areas of Biote's business protocols; specifically, marketing, financial, therapy, forms, patient seminars, company online resources and other topics that may change from time to time. Ability to read and understand medical and scientific studies. Researching and evaluating physicians in assigned areas based on Biote's criteria for appropriateness and suitability. Effectively presenting Biote's training and business program to physicians, Nurse Practitioners, Physician Assistants, office managers and office staff. Recruiting suitable physicians and other practitioners through professional and effective prospecting, appointment setting and presentation skills. Cultivating and maintaining mutually productive partnerships with practitioners to grow new and current practices and maintain patient retention levels of 60% or better. Effectively conducting physician, staff and patient training in the areas of Biote's business protocols; specifically, marketing, financial, therapy, forms, patient seminars, company online resources and other topics that may change from time to time. Securing all required contracts, paperwork and documentation as well as payments and fees as needed for attendees to participate in regular training and certification classes. Conducting and facilitating patient educational seminars as needed for trained practitioners on a monthly basis. Contributing to the development of the practice by assisting the Office Manager/Marketing position with email marketing, social media, referral cards and website information cards. Prospecting for new leads and identifying quality sales prospects from active leads. Attending marketing and sales events for prospects and current customers. Working with customers for sales referrals with new prospects. Updating all relevant sales activities in the Company's CRM system. Closing sales accurately and effectively each month to meet or exceed targets. Responding to all emails received from the customer and Biote employees and related vendors in a timely manner. Performing other related duties as required or requested. As a District Manager, your background should include: Bachelor's degree Strong teamwork, communication (written and oral), client management, and interpersonal skills. Minimum of 3-5 years of sales experience in a business-to-business model, preferably medical device, diagnostics, and/or biotech. Strong work ethic and time management skills Ability to make effective and persuasive communications and technical presentations to physicians, management and/or large groups. Ability to thoroughly understand and communicate the attributes and qualities of Company products using professional selling and closing skills. Proficient in Microsoft Office suite and customer relationship management software. Ability to travel in order to do business, approximately 20% of the month. Scheduled hours are 40 to 50 hours per week Monday through Friday but may be extended as required to execute the tasks assigned. Valid driver's license issued by the state/province in which the individual resides and a good driving record is required. Home office capability is required with reliable high-speed internet access Company Perks: Medical, Dental & Vision Insurance, Virtual Visits/Telemedicine Company Paid Life and AD&D Insurance 15 days of Paid Time Off and Company Holidays 401k with a 3% employer contribution Motus mileage program Other excellent health and wellness benefits in line with our business If you're interested in this awesome opportunity, please apply today!
    $64k-119k yearly est. Auto-Apply 20d ago
  • Care Advisor - Remote

    Sharecare 4.4company rating

    Oklahoma City, OK jobs

    Sharecare is the leading digital health company that helps people - no matter where they are in their health journey - unify and manage all their health in one place. Our comprehensive and data-driven virtual health platform is designed to help people, providers, employers, health plans, government organizations, and communities optimize individual and population-wide well-being by driving positive behavior change. Driven by our philosophy that we are all together better, at Sharecare, we are committed to supporting each individual through the lens of their personal health and making high-quality care more accessible and affordable for everyone. To learn more, visit ***************** . **Job Summary:** CareLinx is looking for a Care Advisor to assist with CareLinx's Payer Operations line of business. CareLinx is a healthcare technology platform that connects families with non-medical, in-home caregivers, and Care Advisors provide support and guidance to families during the caregiver search, interview, and hire process. Once a caregiver match is made, the Care Advisor will follow closely to ensure satisfaction and assist if the member's needs change. This support includes searching for viable caregiver candidates, setting up interviews, helping with the completion of the hiring process, and caregiver retention. You will be a liaison, maintaining relationships with caregivers and providing ongoing support to ensure that members have an exceptional experience while working with their caregivers. As a Care Advisor, you are the expert for members and families about all things CareLinx-related. You need to love interacting with people and be committed to providing stellar customer service and empathetic guidance for members during their in-home care journey. You should also be a team player and be willing to learn about CareLinx's health plan partners. If you think there's alignment with the description above, CareLinx may be the place for you. **Location:** This role is remote, except for candidates located in the Mesa, AZ area. Those based near our Mesa office will be required to work on-site five days per week. **Job Type:** Full-Time, Hourly **Essential Job Functions:** + Assume responsibility for guiding members on the caregiver search journey through relationship building and exceptional communication in a call center environment. + Provide ongoing support after the caregiver hire to maintain the relationship with the family and caregiver and ensure overall satisfaction + Document accurate and complete notes of all family and caregiver interactions in CareLinx's EHR system + Work collaboratively and professionally with other team members and teams within CareLinx + Exhibit excellent verbal and written communication skills via phone, email, and text **Specific Skills/ Attributes:** + Effective time management skills and high attention to detail + Excellent verbal and written communication skills + Superior organization and multitasking capabilities + Goal-driven, problem solver + Professional, confident, outgoing demeanor + Experience working with Microsoft Office Suite + Ability to maintain strict confidentiality, and exercise good judgment + Care Advisors are expected to meet performance goals set forth per CareLinx guidelines + Additional job duties may be assigned on an as-needed basis **Qualifications:** + High school diploma or equivalent, required + Military experience is a plus but not required + Some college-level coursework, preferred + At least one year of experience in a productivity based customer service role, or call center environment or a minimum of 2 years experience in a customer service environment. + Previous healthcare experience preferred Sharecare and its subsidiaries are Equal Opportunity Employers and E-Verify users. Qualified applicants will receive consideration for employment without regard to race, color, sex, national origin, sexual orientation, gender identity, religion, age, equal pay, disability, genetic information, protected veteran status, or other status protected under applicable law. Sharecare is an Equal Opportunity Employer and doesn't discriminate on the basis of race, color, sex, national origin, sexual orientation, gender identity, religion, age, disability, genetic information, protected veteran status,or other non-merit factor.
    $70k-92k yearly est. 60d+ ago
  • Sr Coordinator, Individualized Care

    Cardinal Health 4.4company rating

    Oklahoma City, OK jobs

    Cardinal Health Sonexus Access and Patient Support helps specialty pharmaceutical manufacturers remove barriers to care so that patients can access, afford and remain on the therapy they need for a better quality of life. Our diverse expertise in pharma, payer and hub services allows us to deliver best-in-class solutions-driving brand and patient markers of success. We're continuously integrating advanced and emerging technologies to streamline patient onboarding, qualification and adherence. Our non-commercial specialty pharmacy is centralized at our custom-designed facility outside of Dallas, Texas, empowering manufacturers to rethink the reach and impact of their products. **_Responsibilities_** + Investigate and resolve patient/physician inquiries and concerns in a timely manner + Mediate effective resolution for complex payer/pharmacy issues toward a positive outcome to de-escalate + Proactive follow-up with various contacts to ensure patient access to therapy + Demonstrate superior customer support talents + Prioritize multiple, concurrent assignments and work with a sense of urgency + Must communicate clearly and effectively in both a written and verbal format + Must demonstrate a superior willingness to help external and internal customers + Working alongside teammates to best support the needs of the patient population or will transfer caller to appropriate team member (when applicable) + Maintain accurate and detailed notations for every interaction using the appropriate database for the inquiry + Must self-audit intake activities to ensure accuracy and efficiency for the program + Make outbound calls to patient and/or provider to discuss any missing information as applicable + Assess patient's financial ability to afford therapy and provide hand on guidance to appropriate financial assistance + Documentation must be clear and accurate and stored in the appropriate sections of the database + Must track any payer/plan issues and report any changes, updates, or trends to management + Handle escalations and ensure proper communication of the resolution within required timeframe agreed upon by the client + Ability to effectively mediate situations in which parties are in disagreement to facilitate a positive outcome + Concurrently handle multiple outstanding issues and ensure all items are resolved in a timely manner to the satisfaction of all parties + Support team with call overflow and intake when needed + Proactively following up with various partners including the insurance payers, specialty pharmacies, support organizations, and the patient/physician to facilitate coverage and delivery of product in a timely manner. **_Qualifications_** + 3-6 years of experience, preferred + High School Diploma, GED or technical certification in related field or equivalent experience preferred **_What is expected of you and others at this level_** + Effectively applies knowledge of job and company policies and procedures to complete a variety of assignments + In-depth knowledge in technical or specialty area + Applies advanced skills to resolve complex problems independently + May modify process to resolve situations + Works independently within established procedures; may receive general guidance on new assignments + May provide general guidance or technical assistance to less experienced team members **TRAINING AND WORK SCHEDULES:** Your new hire training will take place 8:00am-5:00pm CT, mandatory attendance is required. This position is full-time (40 hours/week). Employees are required to have flexibility to work any of our shift schedules during our normal business hours of Monday-Friday, 7:00am- 7:00pm CT. **REMOTE DETAILS:** You will work remotely, full-time. It will require a dedicated, quiet, private, distraction free environment with access to high-speed internet. We will provide you with the computer, technology and equipment needed to successfully perform your job. You will be responsible for providing high-speed internet. Internet requirements include the following: Maintain a secure, high-speed, broadband internet connection (DSL, Cable, or Fiber) at the remote location. **Dial-up, satellite, WIFI, Cellular connections are NOT acceptable** . Download speed of 15Mbps (megabyte per second) + Upload speed of 5Mbps (megabyte per second) + Ping Rate Maximum of 30ms (milliseconds) + Hardwired to the router + Surge protector with Network Line Protection for CAH issued equipment **Anticipated hourly range:** $21.50 per hour - $30.70 per hour **Bonus eligible:** No **Benefits:** Cardinal Health offers a wide variety of benefits and programs to support health and well-being. + Medical, dental and vision coverage + Paid time off plan + Health savings account (HSA) + 401k savings plan + Access to wages before pay day with my FlexPay + Flexible spending accounts (FSAs) + Short- and long-term disability coverage + Work-Life resources + Paid parental leave + Healthy lifestyle programs **Application window anticipated to close:** 3/6/2026 *if interested in opportunity, please submit application as soon as possible. The hourly range listed is an estimate. Pay at Cardinal Health is determined by multiple factors including, but not limited to, a candidate's geographical location, relevant education, experience and skills and an evaluation of internal pay equity. _Candidates who are back-to-work, people with disabilities, without a college degree, and Veterans are encouraged to apply._ _Cardinal Health supports an inclusive workplace that values diversity of thought, experience and background. We celebrate the power of our differences to create better solutions for our customers by ensuring employees can be their authentic selves each day. Cardinal Health is an Equal_ _Opportunity/Affirmative_ _Action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, ancestry, age, physical or mental disability, sex, sexual orientation, gender identity/expression, pregnancy, veteran status, marital status, creed, status with regard to public assistance, genetic status or any other status protected by federal, state or local law._ _To read and review this privacy notice click_ here (***************************************************************************************************************************
    $21.5-30.7 hourly 8d ago
  • Integration Specialist (Epic Application Analyst - Bridges)

    Saint Francis Health System 4.8company rating

    Oklahoma City, OK jobs

    **Current Saint Francis Employees - Please click HERE (*************************************************************** **to login and apply.** Full Time Days Job Summary: The Integration Specialist supports interfaces and integration engine functions. This role focuses primarily on the interface engine Cloverleaf with a secondary focus on Epic Bridges. Understands requirements from various hospitals and practices regarding their Health Information Exchange needs. Minimum Education: High School Diploma or GED. Bachelor's degree in Computer Science, Engineering or Math, preferred. Licensure, Registration and/or Certification: Cloverleaf Level II and/or Epic Bridges certification, preferred. Work Experience: 3 - 4 years related experience. Knowledge, Skills and Abilities: Knowledge of Standards (HL7 V2.X, HL7 CDA, XML), Environment (AIX, Linux, Windows). Languages (TCL), Databases (SQLite.), Protocols ITCP/IP, SOAP, SFTP, REST API), and Management Tool (Teams, Microsoft Office 360). Essential Functions and Responsibilities: Interface development, validation, and deployment using the Cloverleaf Integration Engine and Epic Bridges. Interface support and maintenance, including after-hours support. File Transfer development, support, and maintenance. Provide functional support to Application and testing teams. Provide quality documentation and status updates. Understand requirements from various Hospitals and Practices regarding their Health Information Exchange needs. Review and modify interfaces to ensure technical accuracy, security, and reliability. Decision Making: Independent judgment in planning sequence of operations and making minor decisions in a complex technical or professional field. Working Relationships: Works with internal and/or external customers via telephone or face to face interaction. Works with other healthcare professionals and staff. Special Job Dimensions: Ability to travel as required for Epic training. Ability to travel to remote work sites as needed. Supplemental Information: This document generally describes the essential functions of the job, and the physical demands required to perform the job. This compilation of essential functions and physical demands is not all inclusive nor does it prohibit the assignment of additional duties. Information Technology Patients, Affiliates and Interface Systems - Yale Campus Location: Virtual Office, Oklahoma 73105 **EOE Protected Veterans/Disability**
    $59k-98k yearly est. 24d ago
  • Claims Auditor- Remote

    American Health Partners 4.0company rating

    Oklahoma City, OK jobs

    American Health Plans, a division of Franklin, Tennessee-based American Health Partners Inc. owns and operates Institutional Special Needs Plans (I-SNPs) for seniors who reside in long-term care facilities. In partnership with nursing home operators, these Medicare Advantage plans manage medical risk by improving patient care to reduce emergency room visits and avoidable hospitalizations. This division currently operates in Tennessee, Georgia, Missouri, Kansas, Oklahoma, Utah, Texas, Mississippi, Louisiana, Iowa, and Idaho with planned expansion into other states in 2024. For more information, visit AmHealthPlans.com. If you would like to be part of a collaborative, supportive and caring team, we look forward to receiving your application! Benefits and Perks include: * Affordable Medical/Dental/Vision insurance options * Generous paid time-off program and paid holidays for full time staff * TeleMedicine 24/7/365 access to doctors * Optional short- and long-term disability plans * Employee Assistance Plan (EAP) * 401K retirement accounts * Employee Referral Bonus Program ESSENTIAL JOB DUTIES: To perform this job, an individual must accomplish each essential function satisfactorily, with or without a reasonable accommodation. * Conduct pre-pay and post-pay audits to ensure accurate claims payments and denials * Ensure regulatory compliance and overall quality and efficiency by utilizing strong working knowledge of claims processing standards * Work closely with delegated claim processor to ensure errors are reviewed and corrected prior to final payment * Work assigned claim projects to completion * Provide a high level of customer service to internal and external customers; achieve quality and productivity goals * Escalate appropriate claims/audit issues to management as required; follow departmental/organizational policies and procedures * Maintain production and quality standards as established by management * Participate in and support ad-hoc audits as needed * Other duties as assigned JOB REQUIREMENTS: * Proficient in processing/auditing claims for Medicare and Medicaid plans * Strong knowledge of CMS requirements regarding claims processing, especially regarding skilled nursing facilities and other complex claim processing rules and regulations * Current experience with both Institutional and Professional claim payments * Knowledge of automated claims processing systems * Hybrid role that may require 2-3 days per week onsite at the Franklin, TN office. REQUIRED QUALIFICATIONS: * Experience: * Two (2) years' experience with complex claims processing and/or auditing experience in the health insurance industry or medical health care delivery system * Two (2) years' experience in managed healthcare environment related to claims processing/audit * Two (2) years' experience with standard coding and reference materials used in a claim setting, such as CPT4, ICD10 and HCPCS * Two (2) years' experience with CMS requirements regarding claims processing; especially Skilled Nursing Facility and other complex claim processing rules and regulations * Two (2) years' experience processing/auditing claims for Medicare and Medicaid plans * License/Certification(s): * Coding certification preferred EQUAL OPPORTUNITY EMPLOYER Our Organization does not discriminate based on race, color, religion, sex, handicap, disability, age, marital status, sexual orientation, national origin, veteran status, or any other characteristic(s) protected by federal, state, and local laws. The Organization will also make reasonable accommodations for qualified individuals with disabilities should a request for an accommodation be made. This employer participates in E-Verify.
    $43k-53k yearly est. 37d ago
  • Head of Sales Strategy & Planning

    Zoom 4.6company rating

    Oklahoma City, OK jobs

    What you can expect The Head of Sales Strategy & Planning is a senior leadership role focused on driving sales strategy, planning, and performance management throughout the organization. This position bridges executive strategy, revenue operations, and execution. As a strategic advisor to the Chief Revenue Officer and executive leadership, responsibilities include strategic planning, territory design, quota setting, compensation frameworks, process optimization, and governance. Collaboration with Sales, Marketing, Finance, and Product leaders is essential to create data-driven strategies, improve sales performance, and equip the sales team to achieve revenue goals. This role is critical for aligning sales operations with organizational objectives. About the Team The Sales Strategy & Planning team establishes the framework for the sales organization's operations, planning, and success metrics. Collaboration spans Sales, Marketing, Finance, Product, and Operations to develop territories, quotas, coverage models, and performance systems informed by data and business insights. This ensures sales teams remain focused, supported, and aligned for success, enabling the company to grow effectively while navigating evolving markets and opportunities. What we're looking for + Demonstrate expertise leading sales strategy, sales/revenue operations, business operations, or consulting work within a B2B or SaaS environment. + Demonstrate extensive knowledge in sales planning and performance oversight, covering forecasting, analytics, compensation structures, territory organization, and market-entry strategies. + Demonstrate ability to connect operational execution to broader business strategy, clearly articulating the "why" behind decisions and trade-offs. + Demonstrate expertise in collaborating with senior leaders and influencing diverse teams using analytical insights and well-organized proposals. + Demonstrate extensive analytical, financial modeling, communication, and problem-solving skills, with experience using CRM and analytics tools to inform decisions. + Demonstrate expertise in building, leading, and developing teams within strategy, planning, analytics, or operations functions to achieve high performance. + Demonstrate experience building, leading, and developing high-performing teams across strategy, planning, analytics, or operations functions. + Support the scaling of a sales team during periods of rapid expansion or substantial organizational change. + Possess expertise in using planning or analytics tools like Salesforce, Tableau, or Anaplan alongside foundational CRM and reporting capabilities. Salary Range or On Target Earnings: Minimum: $184,300.00 Maximum: $403,200.00 In addition to the base salary and/or OTE listed Zoom has a Total Direct Compensation philosophy that takes into consideration; base salary, bonus and equity value. Note: Starting pay will be based on a number of factors and commensurate with qualifications & experience. We also have a location based compensation structure; there may be a different range for candidates in this and other locations At Zoom, we offer a window of at least 5 days for you to apply because we believe in giving you every opportunity. Below is the potential closing date, just in case you want to mark it on your calendar. We look forward to receiving your application! Anticipated Position Close Date: 01/22/26 Ways of WorkingOur structured hybrid approach is centered around our offices and remote work environments. The work style of each role, Hybrid, Remote, or In-Person is indicated in the job description/posting. BenefitsAs part of our award-winning workplace culture and commitment to delivering happiness, our benefits program offers a variety of perks, benefits, and options to help employees maintain their physical, mental, emotional, and financial health; support work-life balance; and contribute to their community in meaningful ways. Click Learn (********************************* for more information. About UsZoomies help people stay connected so they can get more done together. We set out to build the best collaboration platform for the enterprise, and today help people communicate better with products like Zoom Contact Center, Zoom Phone, Zoom Events, Zoom Apps, Zoom Rooms, and Zoom Webinars.We're problem-solvers, working at a fast pace to design solutions with our customers and users in mind. Find room to grow with opportunities to stretch your skills and advance your career in a collaborative, growth-focused environment. Our Commitment At Zoom, we believe great work happens when people feel supported and empowered. We're committed to fair hiring practices that ensure every candidate is evaluated based on skills, experience, and potential. If you require an accommodation during the hiring process, let us know-we're here to support you at every step. If you need assistance navigating the interview process due to a medical disability, please submit an Accommodations Request Form (https://form.asana.com/?k=OIuqpO5Tv9XQTWp1bNYd8w&d=1***********3361) and someone from our team will reach out soon. This form is solely for applicants who require an accommodation due to a qualifying medical disability. Non-accommodation-related requests, such as application follow-ups or technical issues, will not be addressed. #LI-Remote We believe that the unique contributions of all Zoomies is the driver of our success. To make sure that our products and culture continue to incorporate everyone's perspectives and experience we never discriminate on the basis of race, religion, national origin, gender identity or expression, sexual orientation, age, or marital, veteran, or disability status. Zoom is proud to be an equal opportunity workplace and is an affirmative action employer. All your information will be kept confidential according to EEO guidelines
    $184.3k-403.2k yearly 28d ago
  • Billing Manager (Remote) - Veterans Evaluation Services

    Maximus 4.3company rating

    Oklahoma City, OK jobs

    Description & Requirements Maximus is currently hiring a Billing Manager to join the finance team on our Veterans Evaluation Services (VES) Program. This is a remote opportunity. The Billing Manager is responsible for providing critical support, management, and execution of the department's processes. The department is responsible for the review and approval of mission-critical vendor invoices and costs supporting operations. This involves monitoring, management, and guidance of staff, collaboration with third-party account managers and direct support of the Program Finance Leadership. The Billing manager oversees processes that ensure accuracy of vendor invoices & resolves discrepancies of contractually governed billed items, in addition to other duties as assigned. Must provide key analytical support and reconciliation of pre, current, and post billed items or various metrics as requested. This position will be a key liaison between Operations and Finance and will be responsible for providing direct support to the Finance organization within the Federal VES Program. Due to contract requirements, only US Citizen or a Green Card holder can be considered for this opportunity. Essential Duties and Responsibilities: - Oversee the development and implementation of innovative methodologies to improve service levels and overall operational efficiency. - Manage the project's quality assurance and training programs. - Monitor performance against key indicators established internally or by the clients - Responsible for cash application of premium payments, invoice and statement generation, mailing and financial reporting. - Responsible for daily and monthly financial reconciliation. - Ensure appropriate financial and system controls are operating in compliance with standard audit procedures. - Manage audits of operations. - Develop and implement operational policies and procedures in collaboration with other key stakeholders. - Establish and maintain effective relationships with clients and other external entities. - Monitor SLAs and hold team accountable for reviewing and approving third-party invoices - including validation of services performed - to ensure timely payment. - Work directly with third-party account managers to ensure records are reconciled; monitor troubleshooting and remediation as needed. - Support IT team with system enhancements or modifications of workflow with an objective of streamlining processes. - Candidates residing in the Eastern or Central Time Zones (EST/CST) highly preferred. - Must be willing and able to work over 40 hours when required by the responsibilities of the role. - Please note upon hire, Veteran Evaluation Services (VES), a Maximus Co. will provide all necessary computer equipment that is to be utilized to fulfil the duties of your role. New hires will not be exempt from using company provided equipment. Home Office Requirements Using Maximus-Provided Equipment: - Internet speed of 20mbps or higher required (you can test this by going to (****************** - Connectivity to the internet via either Wi-Fi or Category 5 or 6 ethernet patch cable to the home router - Private work area and adequate power source - Must currently and permanently reside in the Continental US Minimum Requirements - Bachelor's degree in related field. - 5-7 years of relevant professional experience required. - Equivalent combination of education and experience considered in lieu of degree. EEO Statement Maximus is an equal opportunity employer. We evaluate qualified applicants without regard to race, color, religion, sex, age, national origin, disability, veteran status, genetic information and other legally protected characteristics. Pay Transparency Maximus compensation is based on various factors including but not limited to job location, a candidate's education, training, experience, expected quality and quantity of work, required travel (if any), external market and internal value analysis including seniority and merit systems, as well as internal pay alignment. Annual salary is just one component of Maximus's total compensation package. Other rewards may include short- and long-term incentives as well as program-specific awards. Additionally, Maximus provides a variety of benefits to employees, including health insurance coverage, life and disability insurance, a retirement savings plan, paid holidays and paid time off. Compensation ranges may differ based on contract value but will be commensurate with job duties and relevant work experience. An applicant's salary history will not be used in determining compensation. Maximus will comply with regulatory minimum wage rates and exempt salary thresholds in all instances. Accommodations Maximus provides reasonable accommodations to individuals requiring assistance during any phase of the employment process due to a disability, medical condition, or physical or mental impairment. If you require assistance at any stage of the employment process-including accessing job postings, completing assessments, or participating in interviews,-please contact People Operations at **************************. Minimum Salary $ 85,000.00 Maximum Salary $ 105,000.00
    $36k-50k yearly est. Easy Apply 7d ago
  • ServiceNow Application Analyst, ITOM, CMDB

    Idexx Laboratories 4.8company rating

    Oklahoma jobs

    Join our dynamic and forward-thinking team at IDEXX as a ServiceNow Application Analyst focused on IT Operations Management (ITOM) and Configuration Management Database (CMDB). Our team is currently working on projects to enhance our initial CMDB implementation by focusing on increasing the quality, comprehensiveness, and reliability of our CMDB. We believe the foundation of a resilient IT ecosystem begins with a mature and trusted CMDB, enabling streamlined security operations, proactive service delivery, and opportunities for further automation. In this ServiceNow Application Analyst role, you will be responsible for maintaining, optimizing, and ensuring the ongoing health, accuracy, and reliability of our CMDB. You will partner closely with technical stakeholders, data owners, and process managers across IT, Security, and Service Management to uphold the integrity of our CMDB and drive operational excellence. Your responsibilities will center on vigilant monitoring, proactive problem-solving, and hands-on maintenance, ensuring that the CMDB remains up to date and accurate for our key stakeholders of the platform. If you are passionate about empowering IT operations through a world-class CMDB and thrive in a collaborative, mission-driven environment, we welcome your application and look forward to advancing together. In this role, you will…. Monitor and maintain the ongoing health, accuracy, and completeness of the CMDB, ensuring it meets organizational standards and stakeholder needs. Perform day-to-day operational tasks, including data quality reviews, reconciliation, CI lifecycle management, and exception handling. Identify, diagnose, and resolve issues impacting the CMDB, either independently or in collaboration with ServiceNow developers and other technical teams. Partner with stakeholders across IT, Security, and Service Management to understand their requirements and help translate them into actionable CMDB use cases. Work with data owners and process managers to enforce proper CI ownership, data stewardship, and process adherence. Support ServiceNow discovery, integration, and automation processes to ensure accurate and timely CI data population. Provide guidance and training to stakeholders on CMDB best practices, data consumption, and reporting. Assist with audits, compliance reviews, and reporting related to CMDB data quality and configuration management processes. Document processes, procedures, and knowledge articles to support operational continuity and CMDB maturity. What You Will Need to Succeed… 3-5+ years of hands-on experience supporting and maintaining a ServiceNow CMDB in a large, complex IT environment. Strong understanding of CMDB data models, CI lifecycle, discovery, reconciliation, and data quality management. Experience with day-to-day CMDB operations, including troubleshooting, issue resolution, and stakeholder engagement. Familiarity with ServiceNow ITOM modules (e.g., Discovery, Service Mapping) and integration points. Excellent analytical and problem-solving skills, with keen attention to detail and data accuracy. Ability to communicate technical concepts to both technical and non-technical audiences. Experience partnering with IT, Security, and Service Management teams to deliver business value through CMDB insights and capabilities. Basic scripting or workflow automation skills (JavaScript, Flow Designer, or similar), a plus but not required. Location: 100% remote with the preference of EST or CST. What you can expect from us: Base annual salary target: $90000 to $100000 (yes, we do have flexibility if needed) Opportunity for annual cash bonus Health / Dental / Vision Benefits Day-One 5% matching 401k Additional benefits including but not limited to financial support, pet insurance, mental health resources, volunteer paid days off, employee stock program, foundation donation matching, and much more! Why IDEXX? We're proud of the work we do, because our work matters. An innovation leader in every industry we serve, we follow our Purpose and Guiding Principles to help pet owners worldwide keep their companion animals healthy and happy, to ensure safe drinking water for billions, and to help farmers protect livestock and poultry from diseases. We have customers in over 175 countries and a global workforce of over 10,000 talented people. So, what does that mean for you? We enrich the livelihoods of our employees with a positive and respectful work culture that embraces challenges and encourages learning and discovery. At IDEXX, you will be supported by competitive compensation, incentives, and benefits while enjoying purposeful work that drives improvement. Let's pursue what matters together. IDEXX values a diverse workforce and workplace and strongly encourages women, people of color, LGBTQ+ individuals, people with disabilities, members of ethnic minorities, foreign-born residents, and veterans to apply. IDEXX is an equal opportunity employer. Applicants will not be discriminated against because of race, color, creed, sex, sexual orientation, gender identity or expression, age, religion, national origin, citizenship status, disability, ancestry, marital status, veteran status, medical condition, or any protected category prohibited by local, state, or federal laws. #LI-REMOTE
    $90k-100k yearly Auto-Apply 60d+ ago
  • Project Manager - Strategic Workforce Analytics (Remote)

    Maximus 4.3company rating

    Tulsa, OK jobs

    Description & Requirements The Project Manager-Strategic Workforce Analytics will lead the design, implementation, and continuous improvement of Resource Management (RM) processes and system, primarily leveraging Eightfold and integrated platforms with a goal of establishing Resource Management as a structured, enterprise-wide program. This role primarily supports Strategic Workforce Planning (SWP) but is matrixed to support Learning & Organizational Development (L&OD), HRIS, and Operations, driving a strategic, scalable approach to resource management and workforce analytics. The position combines program management expertise, technical systems fluency, and analytical capabilities to deliver accurate resource planning, actionable insights, and enable proactive workforce decisions such as redeployment, reskilling, and capacity forecasting. Essential Duties and Responsibilities: - Manage system administration and configuration for Eightfold Resource Management, ensuring accurate user access and timely release updates within established guidelines. - Coordinate integration activities across assigned platforms (e.g., Salesforce, Kantata, HRIS) in partnership with IT and vendors. - Maintain resource management workflows and monitor data quality, applying compliance standards and established processes. - Prepare and deliver workforce planning reports and dashboards to support decision-making for assigned business areas. - Conduct routine audits and maintain compliance dashboards ensuring adherence to organizational policies. - Onboard and provide guidance to Resource Managers and stakeholders on resource management processes and best practices. - Facilitate regular workforce planning meetings focused on capacity and resource allocation within assigned business areas. - Collaborate with Talent Acquisition, Learning & Development, Finance, and Operations teams to execute workforce planning activities aligned with business needs. - Identify opportunities for process improvement and implement automation solutions within the scope of resource management operations. - Support departmental initiatives that contribute to workforce planning objectives, ensuring alignment with organizational goals. -Deliver recurring workforce planning dashboards, forecasts, and skills intelligence - partner with stakeholders on future talent strategies based on data (build, bot, buy, borrow). -Partner closely with Solution Architects to get timely insights into future talent demands and capabilities. -Support enterprise initiatives such as reskilling programs, AI accelerator communities, and future workforce readiness. Minimum Requirements - Bachelor's degree in relevant field of study and 5+ years of relevant professional experience required, or equivalent combination of education and experience. -Project Management or consulting experience. -Hands-on experience with Eightfold or other Talent Intelligence and/or Resource Management platform. -Proficiency in data visualization tools and advanced analytics platforms -Strong understanding of data workflows, integrations, and process automation -Excellent facilitation, communication, and stakeholder engagement skills -Data & Analytics experience (such as: SQL, Python, Power BI/Tableau, and forecasting models) -Stakeholder Management & Change Leadership -Proven ability to balance strategic thinking with operational execution. Preferred Experience: -Familiarity with data warehousing concepts and skills-based workforce planning, redeployment, and reskilling frameworks -Background with enterprise transformation projects -Workforce planning/resource management experience -HR Technology Fluency: RM platforms, HRIS, CRM systems -Experience with skills taxonomies and workforce analytics platforms (Eightfold, OneModel, SAP Analytics Cloud, Anaplan) -PMP certification, Agile/Scrum methodologies is a plus #LI-JH1 #maxcorp #HotJobs1223LI #HotJobs1223FB #HotJobs1223X #HotJobs1223TH #TrendingJobs #c0rejobs #HotJobs0113LI #HotJobs0113FB #HotJobs0113X #HotJobs0113TH EEO Statement Maximus is an equal opportunity employer. We evaluate qualified applicants without regard to race, color, religion, sex, age, national origin, disability, veteran status, genetic information and other legally protected characteristics. Pay Transparency Maximus compensation is based on various factors including but not limited to job location, a candidate's education, training, experience, expected quality and quantity of work, required travel (if any), external market and internal value analysis including seniority and merit systems, as well as internal pay alignment. Annual salary is just one component of Maximus's total compensation package. Other rewards may include short- and long-term incentives as well as program-specific awards. Additionally, Maximus provides a variety of benefits to employees, including health insurance coverage, life and disability insurance, a retirement savings plan, paid holidays and paid time off. Compensation ranges may differ based on contract value but will be commensurate with job duties and relevant work experience. An applicant's salary history will not be used in determining compensation. Maximus will comply with regulatory minimum wage rates and exempt salary thresholds in all instances. Accommodations Maximus provides reasonable accommodations to individuals requiring assistance during any phase of the employment process due to a disability, medical condition, or physical or mental impairment. If you require assistance at any stage of the employment process-including accessing job postings, completing assessments, or participating in interviews,-please contact People Operations at **************************. Minimum Salary $ 90,780.00 Maximum Salary $ 122,820.00
    $55k-89k yearly est. Easy Apply 6d ago
  • Provider Contracting Network Rep

    Humana 4.8company rating

    Oklahoma City, OK jobs

    **Become a part of our caring community and help us put health first** The Provider Contracting Professional 2 initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements for an organization that provides health insurance. Provider Contracting Professional 2 + Actively communicates contract terms, payment structures, reimbursement rates to providers internal and external constituents + Negotiating and maintaining contracts with hospital partners to ensure our network meets regulatory and business requirements. + Managing relationships with key providers to support member access, minimize disruption, and maintain competitive advantage. + Ensuring contract terms are implemented accurately and that our organization is protected from risk, both financially and legally. + Supporting cross-functional teams with timely updates on contracting status, rate changes, and network developments. + Managing these contract relationships with large statewide hospital systems requires the team to work with internal and external constituents on all areas of contracting; network management; adequacy and gaps; provider education; conflict resolution; claim escalation and research; compliance initiatives and grievances; joint operating committees; and all other facets of the business while also working closely with our Humana counterparts on enterprise initiatives. **Use your skills to make an impact** **Required Qualifications** + 2 or more years of experience in negotiating managed care contracts with physician specialty, hospital and/or other provider contracts. + Proficiency in analyzing, understanding and communicating financial impact of contract terms, payment structures and reimbursement rates to providers. + Experience with public speaking and presentation skills **Preferred Qualifications** + Bachelor's degree + Experience with ACO/Risk Contracting + Experience with Value Based Contracting + Excellent written and verbal communication skills + Ability to manage multiple priorities in a fast-paced environment + Proficiency in MS Office applications **Additional Information** + Travel to Provider facing meetings as needed based on business needs + Hours- 8am to 5pm EST As part of our hiring process, we will be using an exciting interviewing technology provided by HireVue, a third-party vendor. This technology provides our team of recruiters and hiring managers an enhanced method for decision-making. If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview. If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone. You should anticipate this interview to take approximately 10-15 minutes. If participating in a SMS Text interview, you will be asked a series of questions to which you will be using your cell phone or computer to answer the questions provided. Expect this type of interview to last anywhere from 5-10 minutes. Your recorded interview(s) via text and/or pre-recorded voice will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews. **Work at Home Guidance** To ensure Home or Hybrid Home/Office associates' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria: + At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested + Satellite, cellular and microwave connection can be used only if approved by leadership + Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense. + Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job. + Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information Internal- If you have additional questions regarding this role posting, please send them to the Ask A Recruiter persona by visiting go/vivaengage and searching Ask A Recruiter! Please be sure to provide the requisition number so we may be able to research your request quicker. \#LI-BB1 Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $65,000 - $88,600 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 01-14-2026 **About us** About CarePlus Health Plans: CarePlus Health Plans is a recognized leader in healthcare delivery that has been offering Medicare Advantage health plans in Florida over 23 years. CarePlus strives to help people with Medicare, or both Medicare and Medicaid, achieve their best possible health and wellness through plans with benefits and services they care about. As a wholly owned subsidiary of Humana, CarePlus currently serves Medicare beneficiaries throughout 21 Florida counties. About Humana: Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers, and our company. Through our Humana insurance services, and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************
    $65k-88.6k yearly 6d ago
  • Pre-Bill Coder Specialist - Inpatient

    Advocate Health and Hospitals Corporation 4.6company rating

    Oklahoma jobs

    Department: 10460 Enterprise Revenue Cycle - Facility Production Coding Admin Status: Full time Benefits Eligible: Yes Hours Per Week: 40 Schedule Details/Additional Information: Monday-Friday, Flexible hours This is a REMOTE Opportunity Pay Range $28.05 - $42.10 Prioritizes and codes and abstracts high dollar charts, day after discharge, as well as interim charts, at regular intervals, with a high degree of accuracy. Reviews complex medical documentation at a highly skilled and proficient level from clinicians, qualified health professionals and hospitals to assign diagnosis and procedure codes utilizing ICD CM/PCS, CPT, and HCPCS. Assigns and ensures correct code selection following Official Coding Guidelines and compliance with federal and insurance regulations utilizing an EMR and/or Computer Assisted Coding software. Assigns codes for present on admission, research, Hospital acquired Conditions and Core Measure Indicators for all diagnoses both concurrently and post-discharge. Collaborates with other departments to clarify pre-bill coding documentation issues such for inpatient and outpatient to insure reimbursement and clinical outcomes. Works claim edits for all patient types and may codes consecutive/combined accounts to comply with the 72-hour rule and other account combine scenarios. Completes informal peer-review on inpatient and outpatient coders. Tracks and trends quality information from internal and external sources to partner with the educational team on opportunities. Communicates with Medical Staff, CDI, Post -bill for documentation clarification. Utilizes EMR communication tools to track missing documentation on inpatient queries that require follow-up to facilitate coding in a timely fashion. Partners with HIM, Patient Accounts, and Integrity, when needed, to help resolve issues affecting reimbursement and outcomes. Maintains current knowledge of changes in Inpatient coding and reimbursement guidelines and regulations as well as new applications or settings for coding all types of patients. Must be able to use critical decision-making skills to determine when to query to clarify documentation independently for outcomes, reimbursement and benchmarking. License/Registration/Certification: Must have a certification through American Health Information Management Association (AHIMA) or American Academy of professional Coders (AAPC) Education: Two Year associate degree or equivalent work experience Experience: Five to Seven years of inpatient coding experience in an acute care inpatient setting in an Academic Inpatient Care Tertiary Facility Knowledge, Skills & Abilities Required: Advanced proficiency of ICD, CPT and HCPCS coding guidelines. Advanced knowledge of medical terminology, anatomy and physiology. Excellent computer skills including the use of Microsoft office products, electronic mail, including exposure or experience with electronic coding systems or applications. Excellent communication (oral and written) and interpersonal skills. Excellent organization, prioritization, and reading comprehension skills. Excellent analytical skills, with a high attention to detail. Ability to work independently and exercise independent judgment and decision making. Ability to meet deadlines while working in a fast-paced environment. Ability to take initiative and work collaboratively with others. Physical Requirements and Working Conditions: Exposed to a normal office environment. Must be able to sit for extended periods of time. Must be able to continuously concentrate. Position may be required to travel to other sites; therefore, may be exposed to road and weather hazards. Operates all equipment necessary to perform the job. This indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties. This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties. #REMOTE #LI-Remote Our Commitment to You: Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more - so you can live fully at and away from work, including: Compensation Base compensation listed within the listed pay range based on factors such as qualifications, skills, relevant experience, and/or training Premium pay such as shift, on call, and more based on a teammate's job Incentive pay for select positions Opportunity for annual increases based on performance Benefits and more Paid Time Off programs Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability Flexible Spending Accounts for eligible health care and dependent care expenses Family benefits such as adoption assistance and paid parental leave Defined contribution retirement plans with employer match and other financial wellness programs Educational Assistance Program About Advocate Health Advocate Health is the third-largest nonprofit, integrated health system in the United States, created from the combination of Advocate Aurora Health and Atrium Health. Providing care under the names Advocate Health Care in Illinois; Atrium Health in the Carolinas, Georgia and Alabama; and Aurora Health Care in Wisconsin, Advocate Health is a national leader in clinical innovation, health outcomes, consumer experience and value-based care. Headquartered in Charlotte, North Carolina, Advocate Health services nearly 6 million patients and is engaged in hundreds of clinical trials and research studies, with Wake Forest University School of Medicine serving as the academic core of the enterprise. It is nationally recognized for its expertise in cardiology, neurosciences, oncology, pediatrics and rehabilitation, as well as organ transplants, burn treatments and specialized musculoskeletal programs. Advocate Health employs 155,000 teammates across 69 hospitals and over 1,000 care locations, and offers one of the nation's largest graduate medical education programs with over 2,000 residents and fellows across more than 200 programs. Committed to providing equitable care for all, Advocate Health provides more than $6 billion in annual community benefits.
    $29k-35k yearly est. Auto-Apply 60d+ ago
  • NOC Engineer - Tier III

    Vero Networks 4.2company rating

    Tulsa, OK jobs

    NOC Engineer - Tier III Department: Networks Operations The NOC Engineer - Tier III is a senior technical role within the Vero Network Operations Center (NOC), responsible for ensuring network reliability, performance, and uptime across our national fiber and IP transport infrastructure. This position provides advanced NOC monitoring, troubleshooting, and escalation leadership, supporting internal teams and interfacing directly with engineering, field operations, and vendors. The ideal candidate is a hands-on problem solver and technical mentor with deep experience in fiber transport, IP core networks, and NOC operations. RESPONSIBILITIES Monitor and manage multi-vendor network environments, ensuring high availability of fiber and IP transport services. Lead triage and advanced troubleshooting of complex network events, identifying root causes and driving quick resolution. Coordinate escalations with internal engineering, field operations, and external vendors. Manage network fault isolation, configuration, and maintenance of routers, switches, and optical systems. Conduct proactive network performance analysis, capacity planning, and optimization. Provide Tier III technical support to internal teams: mentor Tier I/II NOC personnel. Oversee change management, upgrades, and maintenance windows to minimize service impact. Maintain detailed documentation, runbooks, and process improvements for network operations. Ensure SLA adherence, service availability, and MTTR targets are consistently achieved. CORE COMPETENCIES There are several competencies required to be successful in this position. The following are some of the most important and definitions of each are included at the end of this job posting: Safety and Security, Quality of work, and Results-Orientation. REQUIRED QUALIFICATIONS 8-10+ years in network operations, engineering, or telecommunications, with proven experience in NOC or ISP environments. Deep expertise in IP networking (BGP, OSPF, MPLS, VLANs, VPNs, QoS) and fiber transport systems (DWDM, CWDM, Ethernet). Hands-on experience with: Juniper (Junos), Cisco, and MikroTik platforms. Calix XGS-PON and access/aggregation network management systems. Fixed wireless and LTE platforms such as Cambium, Telrad, or similar. Advanced diagnostic, analytical, and scripting abilities (Python, shell, or equivalent a plus). Strong understanding of network monitoring, alerting, and telemetry tools. Proven ability to lead technical response during major incidents and guide NOC teams through resolution. Bachelor's degree in computer science, IT, or equivalent experience preferred. JOB DETAILS AND PHYSICAL REQUIREMENTS This has no travel requirements. Must be authorized to work in the United States. This is a staff position. This is a Nonexempt position. This is a Full-Time position. This is a Remote position. The schedule for this position is based on company requirements for the role. At this time the schedule is Monday through Friday with occasional weekend availability as needed to fulfill the core duties of the role. This position requires the ability to sit and work at a desk for extended periods of time, using a computer and other office equipment. This position requires the ability to perform fine motor tasks, such as typing or using a mouse, for extended period of time. ABOUT VERO Vero Broadband was formed to fill a need in unserviceable and underserved communities where access to affordable, reliable broadband simply does not exist. Our goal is to bring the highest quality fiber optic-based broadband services to these communities. In addition, Vero strives to enhance communities by becoming an active partner in these communities by adding jobs, supporting local causes, and helping improve the connectivity of schools and rural healthcare as well. NOTICES Vero participates in E-Verify. Vero will provide the Social Security Administration (SSA) and, if necessary, the Department of Homeland Security (DHS) with information from each new employee's Form I-9 to confirm work authorization. For more information about E-Verify, please visit: **************** This position requires the ability to pass a standard background check upon offer of position. At least 2 professional references are required. CORE COMPETENCY DEFINITIONS Safety and Security: Employees with a competency of safety and security are able to observe safety and security procedures, report potentially unsafe conditions and use equipment and materials properly. At intermediate levels that can determine appropriate action beyond guidelines. At higher levels of competency, employees make proactive suggestions to improve safety and security within their department or across the organization. Quality of work: Employees with high quality of work demonstrate accuracy and thoroughness in their work product. They look for ways to improve and promote quality and can apply feedback to improve performance. A stronger employee will monitor their own work to ensure quality. Results-oriented: Employees who are results-oriented focus on achieving results for the organization or team. Most employees routinely achieve their goals and gradually move on to more challenging tasks. More results-oriented employees go beyond that baseline to deliver exceptional value in their daily work.
    $46k-63k yearly est. Auto-Apply 16d ago
  • Financial Analyst II

    Health Care Service Corporation 4.1company rating

    Tulsa, OK jobs

    At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers. Join HCSC and be part of a purpose-driven company that will invest in your professional development. **Job Summary** This position is responsible for performing moderate to complex Value Based Care Provider performance financial analyses. Some level of financial modeling of Revenue and Cost contribution to VBC financial, MLR performance, preparing all necessary financial analyses, periodic financial statements, analyzing total cost of care and revenue trends. Additional assignments and projects within the business unit. The analyst will also be responsible for monitoring VBC contract financial performance across several programs and financial specific activities. Monitor and perform contracted provider validation and establish control analytics on various types of financial contractual arrangements (all lines of business). Lead workgroup forums, create presentations, and facilitate discussions across varying functional leads to establish a plan of action. Ensure outcomes and standards are defined and executed as standard operating procedures. Manage line of credit process and procedures and overseeing outstanding provider recoupments. **Required Job Qualifications:** + Bachelor Degree in Accounting or Finance. + 4 years experience conducting financial analysis **Preferred Job Qualifications:** + Ability to create Executive business level presentations related to financial topic + Ability to inform VBC provider contract performance risks, and collaborate cross-functionally to perform corrective action when applicable. + Advance expertise PC experience in Windows, Word, Excel, Access, PowerPoint, and other business related/associated databases. + Knowledge of SQL (or similar languages such as VBA) + Experience with Value Based Care arrangements Sponsorship will not be provided for this role. Hybrid: Work in office 3 days a week; work from home 2 days a week. \#LI-LI1 \#LI-Hybrid **Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!** **Pay Transparency Statement:** At Health Care Service Corporation, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From health and wellness benefits, 401(k) savings plan, pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for employees. Learn more about our benefit offerings by visiting ************************************* . The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan. **HCSC Employment Statement:** We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics. **Base Pay Range** $55,900.00 - $123,500.00 Exact compensation may vary based on skills, experience, and location. **Join our talent community and receive the latest HCSC news, content, and be first in line for new job opportunities.** **Join our Talent Community. (******************************************** PA8v\_eHgqFiDb2AuRTqQ)** For more than 80 years, HCSC has been dedicated to expanding access to high-quality, cost-effective health care and equipping our members with information and tools to make the best health care decisions for themselves and their families. As an industry leader, HCSC also has been helping to make the health care system work better for all Americans. To remain a leader, we offer compelling careers that encourage resourcefulness, strategic thought and empower you to make a difference in the lives of our members and their communities. Today, with the industry at an important crossroad, HCSC is reimagining health care and looking for original thinkers who aren't afraid to make innovative contributions. We are an Equal Opportunity Employment employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Learn more about HCSC, our commitment to our members and the opportunity you'll have to improve health care delivery in an open, collaborative environment. HCSC is committed to diversity in the workplace and to providing equal opportunity to employees and applicants. If you are an individual with a disability or a disabled veteran and need an accommodation or assistance in either using the Careers website or completing the application process, you can call us at ************** to request reasonable accommodations. Please note that only **requests for accommodations in the application process** will be returned. All applications, including resumes, must be submitted through HCSC's Career website on-line application process. If you have general questions regarding the status of an existing application, navigate to "candidate home" to view your job submissions. Blue Cross and Blue Shield of Illinois, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of New Mexico, Blue Cross and Blue Shield of Oklahoma, and Blue Cross and Blue Shield of Texas, Divisions of Health Care Service Corporation, a Mutual Legal Reserve Company, and Independent Licensee of the Blue Cross and Blue Shield Association © Copyright 2025 Health Care Service Corporation. All Rights Reserved.
    $55.9k-123.5k yearly 60d+ ago
  • Managing Consulting Director (Remote)

    Maximus 4.3company rating

    Oklahoma City, OK jobs

    Description & Requirements Maximus is hiring a Consulting Managing Director to lead strategic expansion within our Consulting Services practice. This executive-level role will shape the future of public sector consulting, with a focus on Health and Human Services (HHS) programs, including Medicaid, public health, child welfare, SNAP, and other related areas. This opportunity is ideal for a proven consulting leader with extensive state-level public sector experience, deep expertise in Medicaid and HHS programs, and a track record of growing existing markets and pursuing new opportunities within a highly matrixed environment. Ready to shape the future of public sector consulting? Apply today to join our team and make a meaningful difference. Why Maximus? - Work/Life Balance Support - Flexibility tailored to your needs! - • Competitive Compensation - Bonuses based on performance included! - • Comprehensive Insurance Coverage - Choose from various plans, including Medical, Dental, Vision, Prescription, and partially funded HSA. Additionally, enjoy Life insurance benefits and discounts on Auto, Home, Renter's, and Pet insurance. - • Future Planning - Prepare for retirement with our 401K Retirement Savings plan and Company Matching. - •Unlimited Time Off Package - Enjoy UTO, Holidays, and extended sick leave, along with Short and Long Term Disability coverage. - • Holistic Wellness Support - Access resources for physical, emotional, and financial wellness through our Employee Assistance Program (EAP). - • Recognition Platform - Acknowledge and appreciate outstanding employee contributions. - • Tuition Reimbursement - Invest in your ongoing education and development. - • Employee Perks and Discounts - Additional benefits and discounts exclusively for employees. - • Maximus Wellness Program and Resources - Access a range of wellness programs and resources tailored to your needs. - • Professional Development Opportunities-Participate in training programs, workshops, and conferences. - •Licensures and Certifications-Maximus assumes the expenses associated with renewing licenses and certifications for its employees. Essential Duties and Responsibilities: - Lead strategic planning of the Consulting Services division to bolster Maximus' position as a leader in public sector consulting, especially in Health and Human Services programs. - Guide the development and deployment of consulting services addressing complex challenges in core Health and Human Services program areas including Medicaid, public health, Integrated Eligibility, child welfare, SNAP, child and family services, and related domains. - Develop go-to-market strategies for new service lines, partnerships, and geographic regions. - Identify, evaluate, and pursue new and adjacent public sector market opportunities such as transportation, labor, and tax/revenue to expand Maximus' consulting reach beyond traditional domains. - Oversee the development and progress of business development including pipeline activities. - Collaborate with Senior Leadership to set growth targets and monitor progress against set goals. - Develop and communicate a compelling vision for the Consulting Services division that is aligned with Maximus' mission and long-term goals. - Serve as executive sponsor for key accounts, ensuring exceptional client satisfaction and service delivery while interacting with clients to identify issues as well as opportunities for growth. - Champion innovation, best practices, and continuous improvement to ensure sustainability and adaptability across consulting engagements. - Leverage knowledge of policy, program operations, technology trends, and funding mechanisms to design innovative, client-centered solutions with heavy focus on Medicaid and other health related programs. - Serve as a thought leader who will represent Maximus at industry forums, conferences, and client engagements. - Monitor market trends, regulatory changes, and competitive landscape to anticipate client needs, and proactively position Maximus for enhanced relevance and impact. - Foster enduring partnerships with senior government officials, agencies, and stakeholders. - Help build and lead high-performing, diverse teams capable of executing complex consulting assignments by recruiting, retaining, and developing top-tier talent with expertise in Health and Human Services and adjacent industries. - Typically leads multiple teams of directors/senior managers and/or managers and mentors emerging leaders while cultivating a culture of innovation, inclusion, and professional growth. Minimum Requirements - Bachelor's degree or equivalent experience in public administration, IT, business, health policy, or equivalent experience. - 15+ years of progressive leadership experience in public sector management consulting with demonstrable success in Health and Human Services projects. - Proven track record of expanding consulting practices outside established core areas to include launching new service lines and entering new markets. - Deep understanding of state and local government procurement, program operations, and regulatory frameworks relevant to Health and Human Services. - Strong working knowledge of public assistance programs, with an emphasis on Medicaid and health programs and services. - Advanced knowledge in Information Technology (IT) and Artificial Intelligence (AI). - Experience with digital transformation, data analytics, and technology-enabled consulting solutions within the public sector. - Exceptional analytical, strategic thinking, and problem-solving skills. - Outstanding communication skills to include experience presenting to executive audiences and government officials. - Demonstrated experience managing large cross-functional teams and complex client relationships. - Proven leadership in public sector consulting, especially in Medicaid and Health and Human Services (HHS). - Strong executive presence, with experience in state and local consulting. - Skilled in business development, financial oversight, and talent development. - Comfortable in a matrixed, fast-paced environment. - Experience with cross-functional collaboration and succession planning. - Must be able and willing to travel for business up to 25-33% of the time. - Experience in State and Local public sector consulting is required. Home Office Requirements: - Maximus provides company-issued computer equipment - Reliable high-speed internet service * Minimum 20 Mpbs download speeds/50 Mpbs for shared internet connectivity * Minimum 5 Mpbs upload speeds - Private and secure workspace - Must currently and permanently reside in the Continental US #ClinicalServices #LI-Remote #maxcorp #HotJobs1223LI #HotJobs1223FB #HotJobs1223X #HotJobs1223TH #TrendingJobs #c0rejobs EEO Statement Maximus is an equal opportunity employer. We evaluate qualified applicants without regard to race, color, religion, sex, age, national origin, disability, veteran status, genetic information and other legally protected characteristics. Pay Transparency Maximus compensation is based on various factors including but not limited to job location, a candidate's education, training, experience, expected quality and quantity of work, required travel (if any), external market and internal value analysis including seniority and merit systems, as well as internal pay alignment. Annual salary is just one component of Maximus's total compensation package. Other rewards may include short- and long-term incentives as well as program-specific awards. Additionally, Maximus provides a variety of benefits to employees, including health insurance coverage, life and disability insurance, a retirement savings plan, paid holidays and paid time off. Compensation ranges may differ based on contract value but will be commensurate with job duties and relevant work experience. An applicant's salary history will not be used in determining compensation. Maximus will comply with regulatory minimum wage rates and exempt salary thresholds in all instances. Accommodations Maximus provides reasonable accommodations to individuals requiring assistance during any phase of the employment process due to a disability, medical condition, or physical or mental impairment. If you require assistance at any stage of the employment process-including accessing job postings, completing assessments, or participating in interviews,-please contact People Operations at **************************. Minimum Salary $ 225,000.00 Maximum Salary $ 275,000.00
    $83k-167k yearly est. Easy Apply 6d ago
  • Hospital Collector

    Surgical Hospital of Oklahoma LLC 3.4company rating

    Oklahoma City, OK jobs

    Surgical Hospital of Oklahoma has an immediate opening for a full-time Hospital Collector. This position ensures medical/hospital collections are completed with highest quality and integrity and that all work is in full compliance with client contractual agreements. All applicants must have knowledge of medical billing, precertification procedures, hospital collection and denials from insurance companies. Strong knowledge of facility billing/collections procedures is required. Required Knowledge, Skills and Abilities: Excellent working knowledge of insurance carriers' payment regulations including reimbursement, coinsurance, deductibles and contractual adjustments Knowledge of Medicare, Medicaid, Managed Care and Commercial Insurances Must be able to read and interpret EOBs and fee schedule contracts Complete familiarity and understanding of claims, billing codes, and hospital collections Knowledge of how to submit appeals, reconsideration requests, corrected claims and mail claims to secondary insurances Understanding of modifier usage and bill types Review adjudicated claims for timely filling and proper payment to ensure maximum payment is received Knowledge of HIPAA regulations and compliance as related to job performance Strong interpersonal and communications skills Able to work successfully in a team-oriented environment Strong written and oral communications skills High attention to detail and the ability to multi-task Able to perform tasks in Microsoft Word, Excel and other Microsoft Office programs required to complete responsibilities Able to work within/learn other software as required Precertification knowledge/experience This is a remote position based in the OKC metro area All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, or national origin. Job Type: Full-time Benefits: 401(k) 401(k) matching Dental insurance Disability insurance Employee assistance program Employee discount Flexible spending account Health insurance Life insurance Paid time off Vision insurance Work from home Schedule: 8 hour shift Day shift Monday to Friday Experience: Medical collection: 1 year (Preferred) Must have Oklahoma medical collections experience
    $29k-34k yearly est. Auto-Apply 60d+ ago
  • Associate Consultant Activation

    GE Healthcare 4.8company rating

    Shawnee, OK jobs

    The Associate Consultant will be a part of the Command Center team at GEHC. This role will be responsible for helping with product configuration, training and activation of software and consulting services at hospital sites. Accountable for the quality of own work. Subject to direct operations supervision/prescribed work instructions/systems checking. Executes within a well-defined operations framework. There is generally a step by step sequence of standard operational tasks which need to be followed to achieve an end result. This is a remote position open across the continental US. The role will require weekly travel to customer sites Monday-Thursday. **Job Description** **Roles and Responsibilities** + Client facing individual responsible for the delivery of consultancy services at a client site(s). + Developing conceptual knowledge of professional discipline. May include support roles with specialized expertise or technical knowledge in broad area. + Applies general knowledge of business developed through education or past experience. Understands how work of own team contributes to the area. + Resolves issues using established procedures. Consults supervisor or more senior team members for issues outside of defined instructions/parameters. + Collaborates with others to solve issues. For customer facing roles, develops strong customer relationships and serves as the interface between customer and GE. Exchanges technical information, asks questions and checks for understanding. **Required Qualifications** + Bachelor's Degree related to Health Sciences + Proficiency in Microsoft Office Suite especially Excel and Power Point + Excellent communication skills, teamwork + Strong interpersonal and teamwork skills + Strong written and oral communication skills + Demonstrated business acumen and analytical skills + Dependable: able to work independently and consistently meet or exceed performance expectations. + Adaptable: able to adjust work and communication style based on situational needs. + Demonstrate an aptitude for critical thinking to included evaluation of ideas and synthesizing information into insights + The ability to travel 80% (Monday-Thursday weekly) **Desired Characteristics** + Strong oral and written communication skills. Ability to document, plan, market, and execute programs. + Working knowledge/experience in SQL We will not sponsor individuals for employment visas, now or in the future, for this job opening. For U.S. based positions only, the pay range for this position is $72,000.00-$108,000.00 Annual. It is not typical for an individual to be hired at or near the top of the pay range and compensation decisions are dependent on the facts and circumstances of each case. The specific compensation offered to a candidate may be influenced by a variety of factors including skills, qualifications, experience and location. In addition, this position may also be eligible to earn performance based incentive compensation, which may include cash bonus(es) and/or long term incentives (LTI). GE HealthCare offers a competitive benefits package, including not but limited to medical, dental, vision, paid time off, a 401(k) plan with employee and company contribution opportunities, life, disability, and accident insurance, and tuition reimbursement. **Additional Information** GE HealthCare offers a great work environment, professional development, challenging careers, and competitive compensation. GE HealthCare is an Equal Opportunity Employer (****************************************************************************************** . Employment decisions are made without regard to race, color, religion, national or ethnic origin, sex, sexual orientation, gender identity or expression, age, disability, protected veteran status or other characteristics protected by law. GE HealthCare will only employ those who are legally authorized to work in the United States for this opening. Any offer of employment is conditioned upon the successful completion of a drug screen (as applicable). While GE HealthCare does not currently require U.S. employees to be vaccinated against COVID-19, some GE HealthCare customers have vaccination mandates that may apply to certain GE HealthCare employees. **Relocation Assistance Provided:** No
    $72k-108k yearly 6d ago
  • Utilization Management Coordinator (H)- Remote

    Saint Francis Health System 4.8company rating

    Tulsa, OK jobs

    **Current Saint Francis Employees - Please click HERE (*************************************************************** **to login and apply.** This position is ECB status - requires a minimum number of worked hours per month as needed by the department; limited benefit offerings. \#ALDIND The shift for this role would be as needed during the weekdays. Location: Remote Job Summary: Provides administrative and clinical support to the hospital and treatment team throughout the review of patients, their placement in various levels of care and their receipt of necessary services and appropriate discharge planning. UM Coordinators participate in treatment teams, communicating with providers the details of reimbursement issues; also participates in the Patient Care Committee for patient care reviews, and in Utilization Review Staff Committee, providing data and contributing to improvement of internal processes. Provides staff education as needed to further the goals of UR. Minimum Education: Has completed the basic professional curricula of a school of nursing as approved and verified by a state board of nursing, and holds or is entitled to hold a diploma or degree therefrom or Master's degree in Social Work, Counseling or related behavioral health field. Licensure, Registration and/or Certification: Valid multi-state or State of Oklahoma Registered Nurse License, or Clinical Social Worker (LCSW), or Professional Counselor (LPC) license, or Marriage and Family Therapist (LMFT). Work Experience: 3 - 4 years of related experience in behavioral health care, part of which may be experience in Behavioral health managed care. Knowledge, Skills and Abilities: Working knowledge of Microsoft Word, Excel and Access as might be used in the preparation of correspondence and reports. Effective interpersonal, written and oral communication skills. Ability to integrate the analysis of data to discover facts or develop knowledge, concepts or interpretations. Ability to organize and prioritize work in an effective and efficient manner. Ability to be detail oriented as required in the examination of numerical data. Ability to synthesize clinical case data into concise summaries. Essential Functions and Responsibilities: Meets time requirements for review intervals, supplying the required clinical information to obtain authorization. Responds promptly to authorizing entity's need for further detail. Participates in treatment team or Patient Care Committee, providing information about eligibility, benefits and criteria for the selected level of care. Seeks treatment information for use in providing reviews for authorization of services. Contributes to discharge planning. Participates in quality of care process improvement. Identifies QI Triggers for individual patient situations, reporting them promptly to the Process Improvement/Quality Director, to appropriate clinicians and to the UM Manager. Reviews eligibility and benefits of patients, matching the level of care utilization. Assures compliance with Managed Care Behavioral Health standards in the area of UM procedures and documentation to permit accreditation for Laureate and/or to maintain the delegation standards established by the managed care contracts. Investigates and prepares appeals for insurance companies, when denial of reimbursement is related to medical necessity or to other treatment issues. Participates in UM process improvement on an ongoing basis and participates in the UR Staff Committee's process improvement goals. Decision Making: The carrying out of non-routine procedures under constantly changing conditions, in conformance with general instructions from supervisor. Working Relationship: Works directly with patients and/or customers. Works with internal customers via telephone or face to face interaction. Works with external customers via telephone or face to face interaction. Works with other healthcare professionals and staff. Works frequently with individuals at Director level or above. Special Job Dimensions: None. Supplemental Information: This document generally describes the essential functions of the job and the physical demands required to perform the job. This compilation of essential functions and physical demands is not all inclusive nor does it prohibit the assignment of additional duties. Pre-Arrival - Yale Campus Location: Tulsa, Oklahoma 74136 **EOE Protected Veterans/Disability**
    $45k-55k yearly est. 60d+ ago

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