HealthcareCrossing Jobs

Commercial Medical Director - Work At Home - USA-OK-Tulsa

Mon, 26 Jun 2023 00:00:00 CDT

Description The Medical Director actively uses their medical background, experience, and judgement to make determinations whether requested services, requested level of care, and/or requested site of...

Medical Director - Florida Medicaid - USA-OK-Tulsa

Thu, 23 Mar 2023 00:00:00 CDT

Job Information Humana Medical Director - Florida Medicaid in Tulsa Oklahoma Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignme...

AVP, MD, Stars and Risk Adjustment Clinical Strategy and Leadership - USA-OK-Tulsa

Sun, 18 Dec 2022 00:00:00 CST

Job Information Humana AVP, MD, Stars and Risk Adjustment Clinical Strategy and Leadership in Tulsa Oklahoma Description The Healthcare Quality Reporting & Improvement (HQRI) organization is seeking a...

Behavioral Health Medical Director - USA-OK-Tulsa

Fri, 23 Dec 2022 00:00:00 CST

Description The Behavioral Health Medical Director makes determinations regarding prior authorization and retrospective reviews for inpatient and outpatient services to ensure that members receive cl...

Director, Quality Improvement - USA-OK-Tulsa

Fri, 23 Dec 2022 00:00:00 CST

Description The Quality Management Director provides strategic leadership for Humana's Oklahoma Medicaid Quality Program, in alignment with organizational quality and population health goals and ensu...

Associate Vice President, Quality Improvement for Healthy Horizons - USA-OK-Tulsa

Sun, 25 Dec 2022 00:00:00 CST

Job Information Humana Associate Vice President, Quality Improvement for Healthy Horizons in Tulsa Oklahoma Description As a company whose primary focus is on the well-being of its members, Humana is ...

Medical Director-KY Medicaid - USA-OK-Tulsa

Sun, 25 Dec 2022 00:00:00 CST

Description The Medical Director's primary responsibility is the review of medical authorizations or claims to determine the medical necessity of a given service or level of care. The Medical Directo...

Grievances and Appeals Medical Director - Nationwide - USA-OK-Tulsa

Mon, 17 Apr 2023 00:00:00 CDT

Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for Medicare Part C Line of Business. The Medical Director provides medical interp...

Associate VP, Behavioral Strategy - USA-OK-Tulsa

Thu, 20 Apr 2023 00:00:00 CDT

Description Humana is a $90 billion (Fortune 40) market leader in integrated healthcare with a clearly defined purpose to help people achieve lifelong well-being. As a company focused on the health a...

Medical Director - Claims Management - USA-OK-Tulsa

Thu, 20 Apr 2023 00:00:00 CDT

Medical Director - Behavioral Health - Tricare - USA-OK-Tulsa

Thu, 20 Apr 2023 00:00:00 CDT

Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex to complex issues where the analysis of situa...

Medical Director - South Central - USA-OK-Tulsa

Thu, 20 Apr 2023 00:00:00 CDT

Grievances and Appeals Medical Director - Weekends Required - USA-OK-Tulsa

Thu, 20 Apr 2023 00:00:00 CDT

Behavioral Health Medical Director - Tricare - USA-OK-Tulsa

Thu, 04 May 2023 00:00:00 CDT

Description The Behavioral Health Medical Director responsible for behavioral health care strategy and/or operations. The Behavioral Health Medical Director work assignments involve moderately comple...

AVP, Stars and Risk Adjustment National Medical Director - USA-OK-Tulsa

Mon, 01 May 2023 00:00:00 CDT

Job Information Humana AVP, Stars and Risk Adjustment National Medical Director in Tulsa Oklahoma Description The Healthcare Quality Reporting & Improvement (HQRI) organization is seeking a talented P...

RN, Utilization Management - Behavioral Health - USA-OK-Tulsa

Fri, 23 Jun 2023 00:00:00 CDT

Description Full-Time Remote, Telephonic RN opportunity. The Utilization Management Behavioral Health Nurse utilizes behavioral health knowledge and skills to support the coordination, documentation...

Associate Director, Accreditation - USA-OK-Tulsa

Fri, 23 Jun 2023 00:00:00 CDT

Description Humana is seeking an experienced and dynamic Associate Director of Accreditation to manage a team of subject matter experts on NCQA Health Plan Accreditation and NCQA Health Equity Accred...

Director, Pharmacy Clinical Pipeline - USA-OK-Tulsa

Thu, 01 Jun 2023 00:00:00 CDT

Description The Director, Pharmacy Clinical Pipeline oversees the medical and pharmacy drug pipeline tracking and forecasting, supports financial sales analysis and market event news. This position w...

Associate Medical Director - Home-based Medical Care - Oklahoma City - 2173669I - USA-OK-Oklahoma City

Mon, 05 Jun 2023 00:00:00 CDT

Job Code 2173669I * $60,000Student Loan Repayment Bonus or $30,000Sign-on Bonus for individuals who have not previously participated in this program. * Careers at Landmark , part of the Optum and Unit...

Physician GoHealth Moore, OK - USA-OK-Moore

Fri, 09 Jun 2023 00:00:00 CDT

We are se...