Location: Tulsa, OK
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
BASE: For servicing and marketing our products Need 2 Insurance Sales Representatives: $60,000 - $80,000+ 1st Year Potential Need 1 Insurance Sales Manager Trainee: $90,000 - $120,000 1st Year Potential Call for an appointment, SEE what we offer, and YOU BE THE JUDGE! Contact Sharon Ayers at xyz X@ for a one-on-one appointment.
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: $1,828 per week Location: Tulsa, OK Shift Schedule: Nights Assignment Duration: 13 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_tulsa-c443982/job_i1969454422
that put an emphasis on safety and quality of service. In our environment, everyone is an important member of our team. WE ARE Blue Linx (NYSE: BXC), a leading wholesale distributor of building and industrial products in the United States with over 70,000 branded and private-label SKUs, and a broad distribution footprint servicing 50 states.
We have over 2,400 associates and our warehouse associates are critical to our success. Teamwork, integrity, and continuous improvement drive our culture which emphasizes safety and customer service. Apply now and join the Blue Linx team today! Job Details Drivers are Home Every Night, No overnight runs All day time work- Typical start time between
5-6 am depending on load assignments for the day No weekend work - Monday-Friday schedule Flatbed haulding building materials, no tarping. You are responsible for securement (strapping) Safe & Reliable Equipment (newer model equipment) Full Benefits: Medical, Dental, Vision, Prescription, Life Insurance, 401(k) with company match, tuition reimbursement, holiday pay and paid time off (PTO) Responsibilities Accurate and timely delivery of freight and pick-up Load securement and directing the unloading by customer forklift operators Maintain electronic logbook and complete trip reports Manage Proof of Delivery Paperwork from customers Interact professionally with customers; process and communicate
customer issues Maintain daily safety checklist and perform all required DOT inspections Requirements Class A CDL Minimum 21 years of age 12 months of tractor trailer experience in the past 3 years Safe Driving Record (considered on a case-by-case basis): no major accidents/moving violations in past three years, including no DUIs in last 5 years Physical ability to secure loads Ability to read customer orders Other details Job Family Driving Job Function Branch Management Pay Type Hourly Hiring Rate $59,280.00 Qualified drivers, call us at (866) 889-xyz X to speak with a Recruiter Today!
For more details: jobs-search. org/insurance_glenpool-c443938/local-cdl-a-driver-glenpool_i1969564016
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: $1,848 per week Location: Tulsa, OK Shift Schedule: Nights Assignment Duration: 13 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_tulsa-c443982/job_i1971120537
care into " what patients want it to be" through care coordination and communication. Get Involved! With a team that sees about 10 different specialties, you have the opportunity to gain experience in each one. Join the Team! Like our patients, the Main Line Health Family encompasses a wide range of backgrounds and abilities.
Just as each of our patients requires a personalized care plan, each of our employees, physicians, and volunteers, bring distinctive talents to Main Line Health. Regardless of our unique design, we all share a purpose: providing superior service and care. Position-Specific Benefits include: You are eligible for up to 4 weeks of paid time off per year based
on your Full or Part Time status. We also offer a number of employee discounts to various activities, services, and vendors. And employee parking is always free!
Position: Registered Nurse RN - Ambulatory Shift: Full Time, 40 hours/week - Monday-Friday 8 hour day shift. No Weekend or Holiday's! Experience: Preferred: 1. Experience in a clinical nursing setting and/or primary care office. Strong telephone triage experience. 2. Experience with Warfarin management, medication refills and knowledge of insurance information. Education: Graduate of an accredited ASN or BSN nursing program. Licensures/Certifications: Current Pennsylvania RN license. Provider BLS (American Heart Assoc/American
Red Cross) required. Additional Information Requisition ID: 69224Employee Status: Regular Benefit Eligibility: Full-Time Benefits Schedule: Full-time Shift: Day Job Pay Range: $33 - $51.14Job Grade: 212For more details: jobs-search.
org/insurance_wynnewood-c443856/staff-nurse-ambulatory-internal-medicine-wynnewood_i1950051674
clinic when needed. Urology and/or MA experience helpful. Requirements 2+ year of medical insurance verification and pre-certification Proficient computer skills Familiarity with online insurance verification of deductibles and co-insurance calculations Must be detail-oriented and able to handle a fast-paced environment and the ability to multi-task, work under pressure, and provide expert level support to all staff, patients, and referring physician offices with a friendly and professional demeanor.
Job Type: Full-time Pay: $15.00 - $17.00 per hour Schedule: Monday to Friday Education: High school or equivalent (Required) Experience: Insurance verification: 2 years (Required) Work Location: One location
direct patient care, LTAC nurses also play a crucial role in patient education and discharge planning, working with patients and their families to ensure a smooth transition to the next level of care or home. LTAC nurses require a high level of clinical expertise, strong critical thinking skills, and the ability to work effectively in a fast-paced and challenging environment.
They also need excellent communication skills to collaborate effectively with the interdisciplinary team and provide emotional support to patients and their families. Requirements Certification: Some LTAC facilities require certification in Critical Care Registered Nurse (CCRN) or other relevant nursing specialties.
2 years of experience required Job Details Weekly Pay: $1,525 per week Location: Broken Arrow, OK Shift Schedule: Days Assignment Duration: 8 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_broken-arrow-c443979/job_i1970114244
