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... detecting and investigation of potential fraud and provide clinical guidance to ... reviewing of medical records for fraud, waste or abuse as well ... detecting and investigation of potential..
Description The Medicaid Oklahoma Pharmacy Director monitors drug development pipeline, and medical literature, while providing clinical support for internal stakeholders. Utilizes broad understanding of managed care and PBM knowledge to develop, ..
Job Information Humana Medicaid Associate Director, Compliance Nursing in Tulsa Oklahoma Description The Associate Director, Compliance Nursing reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations ..
Description Job Description Summary The Medicaid Oklahoma Pharmacy Director monitors drug development pipeline, and medical literature, while providing clinical support for internal stakeholders. Utilizes broad understanding of managed care and PBM ..
Description Responsibilities The Care Manager, Behavioral Health 2 (BCBA) is responsible for the administration and monitoring of the Autism Care Demonstration (ACD) including coordination of services for ABA Therapy, benefits provided ..
Description The Care Manager, Telephonic Behavioral Health 2 , in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward ..
