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1 - 10 of 13 matches in 0.011 seconds
Senior Data Manager (Compliance) - Oklahoma City, OK (JC173658508)
Last Updated: 2020-11-27
Employer: Humana
Location: Oklahoma City, OK

Description

The Senior Data Manager supports configuration control, data management, and deficiency reporting. The Senior Data Manager works assignments that involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.

Responsibilities

+ Provides oversight to ensure all Contract data conforms…

Compliance Lead (Internal Audit) - Oklahoma City, OK (JC173658547)
Last Updated: 2020-11-27
Employer: Humana
Location: Oklahoma City, OK

Description

The Compliance Lead (Internal Audit) will be responsible for oversight of the organization’s risk management process. The Compliance Lead (Internal Audit) will analyze operations and critically assess compliance with all contract requirements. They will identify and analyze potential sources of loss to minimize risk.

Responsibilities

+ Audits records of…

Enrollee Services Lead - Oklahoma City, OK (JC173658472)
Last Updated: 2020-11-27
Employer: Humana
Location: Oklahoma City, OK

Description

The Enrollee Services Lead (Consumer Service Operations Lead) is responsible for the daily activities across multiple service functional area. Oversees enrollee services for the Medicaid member.

Responsibilities

+ Partner across enrollee services areas to ensure excellence with functions such as installation, implementation, client support, client services, client administration, customer…

Culture & Community Management Lead - Oklahoma City, OK (JC173658530)
Last Updated: 2020-11-27
Employer: Humana
Location: Oklahoma City, OK

Description

The Community Management Lead will provide oversight, guidance, and direction to a team to drive outreach strategies to enrollees throughout the state. He/she builds visibility and credibility of organization’s products and services throughout community via chats, posts, and interactions. Strategizes methods to scale communities and drive greater connections among…

Clinical Strategy and Practice Lead (Behavioral Health) - Ok (JC173658427)
Last Updated: 2020-11-27
Employer: Humana
Location: Tulsa, OK

Description

The Clinical Strategy & Practice Lead will oversee our behavioral health (BH) clinical program for Oklahoma’s Medicaid plan enrollees. They will collaborate closely with the Health Services Director and RVP, Health Services (CMO) to integrate the day-to-day administration and strategic management of behavioral and physical health…

Senior Compliance Professional (JC173438276)
Last Updated: 2020-11-27
Employer: Humana
Location: Tulsa, OK

Description

The Senior Compliance Professional will provide guidance for the development and implementation of Humana’s Oklahoma Medicaid Compliance Program. He/she will serve as the primary point of contact for all Managed Care Organization (MCO) communications regarding compliance issues. He/she will ensure that written policies, procedures, and standards are…

Senior Provider Engagement Professional - Remote (Tulsa/Okla (JC173436923)
Last Updated: 2020-11-27
Employer: Humana
Location: Tulsa, OK

Description

The Senior Provider Engagement Professional develops and grows positive, long-term relationships with physicians, providers and healthcare systems in order to support and improve financial and quality performance within the contracted working relationship with the health plan. The Senior Provider Engagement Professional work assignments involve moderately complex to complex issues…

Senior Coding Educator - Remote Opportunity in OK (JC173437846)
Last Updated: 2020-11-27
Employer: Humana
Location: Tulsa, OK

Description

The Senior Coding Educator identifies opportunities to improve provider documentation and creates an education plan tailored to each assigned provider. The Senior Coding Educator work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.

Responsibilities

The Senior…

Utilization Management Behavioral Health Professional 2 (JC173438428)
Last Updated: 2020-11-27
Employer: Humana
Location: Tulsa, OK

Description

The Utilization Management Behavioral Health Professional 2 utilizes behavioral health knowledge and skills to support the coordination, documentation, and communication of medical services and/or benefit administration determinations. The Utilization Management Behavioral Health Professional 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses…

Oklahoma Senior Medicaid Grievance and Appeals Professional (JC173658482)
Last Updated: 2020-11-27
Employer: Humana
Location: Tulsa, OK

Description

The Senior Grievances & Appeals Professional will be dedicated to the State of Oklahoma business managing inquiries by conducting a comprehensive analytic review of contract requirements. The Senior Grievances & Appeals Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an…

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