Nurse for the Ambetter line of business. The ideal candidate will have Appeals or Utilization Management experience and have knowledge of Inter Qual criteria. Position Purpose: Performs clinical reviews needed to resolve and process appeals by reviewing medical records and clinical data to determine medical necessity for services in accordance with policies, guidelines, and National Committee for Quality Assurance (NCQA) standards.
Prepares case reviews for Medical Directors by researching the appeal, reviewing applicable criteria, and analyzing the basis for the appeal Ensures timely review, processing, and response to appeal in accordance with State, Federal and NCQA standards Communicates
with members, providers, facilities, and other departments regarding appeals requests Generates appropriate appeals resolution communication and reporting for the member and provider in accordance with company policies, State, Federal and NCQA standards Works with leadership to increase the consistency, efficiency, and appropriateness of responses of all appeals requests Partners with interdepartmental teams to improve clinical appeals processes and procedures to prevent recurrences based on industry best practices Performs other duties as assigned Complies with all policies and standards Education/Experience: Requires a Bachelor's degree or graduate from an Accredited School of Nursing and 2
– 4 years of related experience.
Or equivalent experience acquired through accomplishments of applicable knowledge, duties, scope and skill reflective of the level of this position.
Knowledge of NCQA, Medicare and Medicaid regulations preferred. Knowledge of utilization management processes preferred. License/Certification: LPN - Licensed Practical Nurse - State Licensure required or LVN - Licensed Vocational Nurse required or RN - Registered Nurse - State Licensure and/or Compact State Licensure required Our Comprehensive Benefits Package: Flexible work solutions including remote options, hybrid work schedules and dress flexibility, Competitive pay, Paid time off including holidays, Health insurance coverage for you and your dependents, 401(k) and stock purchase plans, Tuition reimbursement and best-in-class training and development.
Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, interaction, interactionual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. For more details: jobs-search. org/insurance_tulsa-c443982/clinical-review-clinician-appeals-tulsa_i1973749292
state of practice EKG certification is recommended and/or a special test may be required, NIHSS (stroke scale) is also recommended Specialty-related certifications are preferred and may be required for specific positions Experience as a Telemetry RN in a hospital setting Minimum of 2 years of experience as an RN Job Details Weekly Pay: $2,462 per week Location: Oklahoma City, OK Shift Schedule: Nights Assignment Duration: 17 Weeks Weekly Hours: 36 Hours Agency Benefits Day 1 Health Insurance (Medical, Dental, Vision), Flexible Housing Options, Guaranteed Stipend: Facility Cancelled Shifts, JACHO Certified, Prestigious Facilities, PTO Program, Weekly Pay, Paid Compliance Cost, Referral Bonuses, Extra Shift Bonuses, 401(k) Plan For more details: jobs-search.
org/insurance_oklahoma-city-c443983/job_i1973798680
for a RN in Oklahoma City, OK. In this position, you’ll work Days 8:30am-5:00pm with our Oncology Infusion Team providing exceptional care to those who have entrusted INTEGRIS Health with their healthcare needs. Those who apply to this RN Oncology position will be eligible to receive a sign-on bonus of $10,000.
If our mission of partnering with people to live healthier lives speaks to you, apply today to learn more about our recently enhanced benefits package for all eligible caregivers including: Front-loaded PTO Employer-funded Short-Term Disability Increased Retirement Match Family Leave after 1 year The Staff Registered Nurse assumes responsibility for the management and delivery
of patient care utilizing the nursing process May be required to float to other units. May be required to participate in on call status. This position requires population specific competencies.
Adheres to National Patient Safety Goals as appropriate based on the level of patient contact this position requires. INTEGRIS is an Equal Opportunity/Affirmative Action Employer. All applicants will receive consideration regardless of membership in any protected status as defined by applicable state or federal law, including protected veteran or disability status. Current licensure as a Registered Nurse (RN) in the State of Oklahoma or current multistate license from a Nurse Licensure Compact
(e NLC) member state. Current BLS certification upon hire, or completion within 30 days of hire.
Must be able to communicate effectively in English. Department specific competencies will be completed in the applicable department during the orientation process. Hospice Only: Current CPR required rather than BLS. Certified Hospice and Palliative Care Nurse (CHPN) preferred. Valid driver's license in the state where employed, available and dependable transportation, ability to drive automobile, and proof of current automobile liability insurance. Radiology Only: Current ACLS certification required. Employee Health: Valid driver's license in the state where employed, available and dependable transportation, ability to drive automobile, and proof of current automobile liability insurance.
INTEGRIS Mental Health: This job prefers, if needed, the incumbents to operate a INTEGRIS-owned vehicle OR personal vehicle (non INTEGRIS-owned) and have a current Oklahoma State Drivers License as well as a driving record which is acceptable to our insurance carrier. Emergency Department Only: PALS certification must be completed within 12 months of hire. ACLS certification completed within 6 months of hire. The Staff Registered Nurse's management of the delivery and documentation of patient care includes, but is not limited to: backssment/re backssments Development of the plan of care Implementation of appropriate patient care interventions Evaluation of appropriate patient care interventions Supervises and coordinates other licensed and non-licensed personnel in the provision of care to patients as assigned Provides guidance and mentorship to non-licensed personnel and students, as appropriate The Staff Registered Nurse reports to the appropriate manager, director, or vice president.
Mental Health staff must be able to assist with physical restraint of patients, utilizing the identified Behavior Management Technique System.
This position may have additional or varied physical demand and/or respiratory fit test requirements. Please consult the Physical Demands Project Share Point site or contact Risk Management/Employee Health for additional information. Potential for exposure to infections and communicable diseases, blood and body fluids, electrical equipment, chemicals. Must follow standard precautions. All applicants will receive consideration regardless of membership in any protected status as defined by applicable state or federal law, including protected veteran or disability status.
Integirs Job ID #93153. Posted job title: RN - Oncology Outpatient Infusion - Days About INTEGRIS Health As the state’s largest not-for-profit and Oklahoma-owned health care system, with hospitals, specialty clinics, family care practices and centers of excellence, INTEGRIS Health is here for you. But medicine isn’t always about caring for the sick. It’s about doing everything in our power to keep our friends and neighbors and every Oklahoman healthy. The future of caring for illness is firmly rooted in wellness. That’s why INTEGRIS Health doctors are here for you every day, with everything from the lifesaving care that can restore your health to wisdom and guidance on staying healthy.
We believe deeply that if we work together — and we work hard — we can all live fuller, healthier lives, and give future generations the gift of true health and well-being. Benefits Employee assistance programs Medical benefits Dental benefits Vision benefits For more details: jobs-search. org/insurance_oklahoma-city-c443983/job_i1973810720
system has a great opportunity for a Register Nurse in Oklahoma City, Oklahoma. In this position, you’ll work 7pm to 7am with our Coronary Care ICU team providing exceptional care to those who have entrusted INTEGRIS Health with their healthcare needs. If our mission of partnering with people to live healthier lives speaks to you, apply today.
Applicants who accept an offer will be eligible to receive a sign-on bonus of $10,000. We invite you to join us as we strive to be The Most Trusted Partner for Health. The Staff Registered Nurse assumes responsibility for the management and delivery of patient care utilizing the nursing process May be required to float to other units. May be required
to participate in on call status. This position requires population specific competencies. Adheres to National Patient Safety Goals as appropriate based on the level of patient contact this position requires.
INTEGRIS is an Equal Opportunity/Affirmative Action Employer. All applicants will receive consideration regardless of membership in any protected status as defined by applicable state or federal law, including protected veteran or disability status. Current licensure as a Registered Nurse (RN) in the State of Oklahoma or current multistate license from a Nurse Licensure Compact (e NLC) member state. Current BLS certification upon hire, or completion within 30 days of hire. Must be
able to communicate effectively in English. Department specific competencies will be completed in the applicable department during the orientation process.
Hospice Only: Current CPR required rather than BLS. Certified Hospice and Palliative Care Nurse (CHPN) preferred. Valid driver's license in the state where employed, available and dependable transportation, ability to drive automobile, and proof of current automobile liability insurance. Radiology Only: Current ACLS certification required. Employee Health: Valid driver's license in the state where employed, available and dependable transportation, ability to drive automobile, and proof of current automobile liability insurance.
INTEGRIS Mental Health: This job prefers, if needed, the incumbents to operate a INTEGRIS-owned vehicle OR personal vehicle (non INTEGRIS-owned) and have a current Oklahoma State Drivers License as well as a driving record which is acceptable to our insurance carrier. Emergency Department Only: PALS certification must be completed within 12 months of hire. ACLS certification completed within 6 months of hire. The Staff Registered Nurse's management of the delivery and documentation of patient care includes, but is not limited to: backssment/re backssments Development of the plan of care Implementation of appropriate patient care interventions Evaluation of appropriate patient care interventions Supervises and coordinates other licensed and non-licensed personnel in the provision of care to patients as assigned Provides guidance and mentorship to non-licensed personnel and students, as appropriate The Staff Registered Nurse reports to the appropriate manager, director, or vice president.
Mental Health staff must be able to assist with physical restraint of patients, utilizing the identified Behavior Management Technique System. This position may have additional or varied physical demand and/or respiratory fit test requirements.
Please consult the Physical Demands Project Share Point site or contact Risk Management/Employee Health for additional information. Potential for exposure to infections and communicable diseases, blood and body fluids, electrical equipment, chemicals. Must follow standard precautions. All applicants will receive consideration regardless of membership in any protected status as defined by applicable state or federal law, including protected veteran or disability status. Integirs Job ID #89479. Posted job title: RN - Coronary Care ICU - Nights About INTEGRIS Health As the state’s largest not-for-profit and Oklahoma-owned health care system, with hospitals, specialty clinics, family care practices and centers of excellence, INTEGRIS Health is here for you.
But medicine isn’t always about caring for the sick. It’s about doing everything in our power to keep our friends and neighbors and every Oklahoman healthy. The future of caring for illness is firmly rooted in wellness. That’s why INTEGRIS Health doctors are here for you every day, with everything from the lifesaving care that can restore your health to wisdom and guidance on staying healthy.
We believe deeply that if we work together — and we work hard — we can all live fuller, healthier lives, and give future generations the gift of true health and well-being. Benefits Employee assistance programs Medical benefits Dental benefits Vision benefits For more details: jobs-search. org/insurance_oklahoma-city-c443983/job_i1971800639
a Registered Nurse in Edmond, OK. In this position, you’ll work the night shift with our Labor & Delivery team providing exceptional care to those who have entrusted INTEGRIS Health with their healthcare needs. If our mission of partnering with people to live healthier lives speaks to you, apply today.
Those who apply to this Registered Nurse - Labor & Delivery position, may be eligible to receive a sign-on bonus of $10,000. We invite you to join us as we strive to be The Most Trusted Partner for Health. The Staff Registered Nurse assumes responsibility for the management and delivery of patient care utilizing the nursing process May be required to float to other units. May be required
to participate in on call status. This position requires population specific competencies. Adheres to National Patient Safety Goals as appropriate based on the level of patient contact this position requires.
INTEGRIS is an Equal Opportunity/Affirmative Action Employer. All applicants will receive consideration regardless of membership in any protected status as defined by applicable state or federal law, including protected veteran or disability status. Current licensure as a Registered Nurse (RN) in the State of Oklahoma or current multistate license from a Nurse Licensure Compact (e NLC) member state. Current BLS certification upon hire, or completion within 30 days of hire. Must be
able to communicate effectively in English. Department specific competencies will be completed in the applicable department during the orientation process.
Hospice Only: Current CPR required rather than BLS. Certified Hospice and Palliative Care Nurse (CHPN) preferred. Valid driver's license in the state where employed, available and dependable transportation, ability to drive automobile, and proof of current automobile liability insurance. Radiology Only: Current ACLS certification required. Employee Health: Valid driver's license in the state where employed, available and dependable transportation, ability to drive automobile, and proof of current automobile liability insurance.
INTEGRIS Mental Health: This job prefers, if needed, the incumbents to operate a INTEGRIS-owned vehicle OR personal vehicle (non INTEGRIS-owned) and have a current Oklahoma State Drivers License as well as a driving record which is acceptable to our insurance carrier. Emergency Department Only: PALS certification must be completed within 12 months of hire. ACLS certification completed within 6 months of hire. The Staff Registered Nurse's management of the delivery and documentation of patient care includes, but is not limited to: backssment/re backssments Development of the plan of care Implementation of appropriate patient care interventions Evaluation of appropriate patient care interventions Supervises and coordinates other licensed and non-licensed personnel in the provision of care to patients as assigned Provides guidance and mentorship to non-licensed personnel and students, as appropriate The Staff Registered Nurse reports to the appropriate manager, director, or vice president.
Mental Health staff must be able to assist with physical restraint of patients, utilizing the identified Behavior Management Technique System. This position may have additional or varied physical demand and/or respiratory fit test requirements.
Please consult the Physical Demands Project Share Point site or contact Risk Management/Employee Health for additional information. Potential for exposure to infections and communicable diseases, blood and body fluids, electrical equipment, chemicals. Must follow standard precautions. All applicants will receive consideration regardless of membership in any protected status as defined by applicable state or federal law, including protected veteran or disability status. Integirs Job ID #93287. Posted job title: Registered Nurse - L&D - Nights About INTEGRIS Health As the state’s largest not-for-profit and Oklahoma-owned health care system, with hospitals, specialty clinics, family care practices and centers of excellence, INTEGRIS Health is here for you.
But medicine isn’t always about caring for the sick. It’s about doing everything in our power to keep our friends and neighbors and every Oklahoman healthy. The future of caring for illness is firmly rooted in wellness. That’s why INTEGRIS Health doctors are here for you every day, with everything from the lifesaving care that can restore your health to wisdom and guidance on staying healthy.
We believe deeply that if we work together — and we work hard — we can all live fuller, healthier lives, and give future generations the gift of true health and well-being. Benefits Employee assistance programs Medical benefits Dental benefits Vision benefits For more details: jobs-search. org/insurance_edmond-c443978/job_i1973809664
OK. In this position, you’ll work days with our Jim Thorpe Nursing team providing exceptional care to those who have entrusted INTEGRIS Health with their healthcare needs. If our mission of partnering with people to live healthier lives speaks to you, apply today.
Those who apply to this Registered Nurse - Jim Thorpe Nursing position, may be eligible to receive a sign-on bonus of $10,000. We invite you to join us as we strive to be The Most Trusted Partner for Health. The Staff Registered Nurse assumes responsibility for the management and delivery of patient care utilizing the nursing process May be required to float to other units. May be required to participate in on call status. This
position requires population specific competencies. Adheres to National Patient Safety Goals as appropriate based on the level of patient contact this position requires.
INTEGRIS is an Equal Opportunity/Affirmative Action Employer. All applicants will receive consideration regardless of membership in any protected status as defined by applicable state or federal law, including protected veteran or disability status. Current licensure as a Registered Nurse (RN) in the State of Oklahoma or current multistate license from a Nurse Licensure Compact (e NLC) member state. Current BLS certification upon hire, or completion within 30 days of hire. Must be able to communicate effectively in English.
Department specific competencies will be completed in the applicable department during the orientation process.
Hospice Only: Current CPR required rather than BLS. Certified Hospice and Palliative Care Nurse (CHPN) preferred. Valid driver's license in the state where employed, available and dependable transportation, ability to drive automobile, and proof of current automobile liability insurance. Radiology Only: Current ACLS certification required. Employee Health: Valid driver's license in the state where employed, available and dependable transportation, ability to drive automobile, and proof of current automobile liability insurance. INTEGRIS Mental Health: This job prefers, if needed, the incumbents to operate a INTEGRIS-owned vehicle OR personal vehicle (non INTEGRIS-owned) and have a current Oklahoma State Drivers License as well as a driving record which is acceptable to our insurance carrier.
Emergency Department Only: PALS certification must be completed within 12 months of hire. ACLS certification completed within 6 months of hire. The Staff Registered Nurse's management of the delivery and documentation of patient care includes, but is not limited to: backssment/re backssments Development of the plan of care Implementation of appropriate patient care interventions Evaluation of appropriate patient care interventions Supervises and coordinates other licensed and non-licensed personnel in the provision of care to patients as assigned Provides guidance and mentorship to non-licensed personnel and students, as appropriate The Staff Registered Nurse reports to the appropriate manager, director, or vice president.
Mental Health staff must be able to assist with physical restraint of patients, utilizing the identified Behavior Management Technique System. This position may have additional or varied physical demand and/or respiratory fit test requirements.
Please consult the Physical Demands Project Share Point site or contact Risk Management/Employee Health for additional information. Potential for exposure to infections and communicable diseases, blood and body fluids, electrical equipment, chemicals. Must follow standard precautions. All applicants will receive consideration regardless of membership in any protected status as defined by applicable state or federal law, including protected veteran or disability status. Integirs Job ID #92237. Posted job title: RN - Jim Thorpe Nursing - Nights About INTEGRIS Health As the state’s largest not-for-profit and Oklahoma-owned health care system, with hospitals, specialty clinics, family care practices and centers of excellence, INTEGRIS Health is here for you.
But medicine isn’t always about caring for the sick. It’s about doing everything in our power to keep our friends and neighbors and every Oklahoman healthy. The future of caring for illness is firmly rooted in wellness. That’s why INTEGRIS Health doctors are here for you every day, with everything from the lifesaving care that can restore your health to wisdom and guidance on staying healthy. We believe deeply that if we work together — and we work hard — we can all live fuller, healthier lives, and give future generations the gift of true health and well-being.
Benefits Employee assistance programs Medical benefits Dental benefits Vision benefits For more details: jobs-search. org/insurance_edmond-c443978/job_i1973584332
connect with each other and our customers on a personal level. At R. E. West, we have names, not employee numbers. Family Oriented isn t just a bullet point on an advertisement here; we ve been family owned, operated, and focused since our inception over 50 years ago.
Call (855) 932-xyz X to speak with a Recruiter Today! RE. West Drivers in the specialized freight division w / LESS THAN 2 years of experience average over $70k per year. RE. West Drivers in the specialized freight division w / 2 years OR MORE of experience average over $95k per year. We are offering a sign-on bonus to experienced dry van and flatbed/RGN drivers of up to $5,000! We can accommodate drivers with varying levels
of experience. Those with at least one year of verifiable OTR experience hauling oversized / permitted loads on step-deck and/or RGN will be eligible for top pay and bonuses.
Drivers with experience in OTR dry-van, reefer, non-permitted flatbed, etc. are also eligible for attractive pay packages and bonuses. Much of the freight hauled from the Midwest will be over-dimensional and require permits and/or escorts. Position details include: Pay will be based on experience and the amount of home-time desired. Hourly Pay is available to those that qualify Up to $5,000 sign-on bonus paid in installments over first 2 years of employment Absolutely no tarping! Minimum time out of 2 3 weeks based
on location. Must have, or be able to obtain, a TWIC Card Additional Compensation and Benefits include: $5,000 incentive for military veterans in good standing Customizable health, dental and vision insurance.
Company paid long term disability and life insurance (25k) 401k with company match Rider Program Pet Policy Weekly Pay with Direct Deposit For more information on this position, please call our recruiting department at (855) 932-xyz X. For more details: jobs-search. org/insurance_moore-c443976/cdl-a-flatbed-regional-driver-moore_i1973534530
