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Tulsa, OK, USA ● Req #480Tuesday, April 16, 2024JOB SUMMARY: The Vendor Services Intern’s primary responsibility will be data entry of relevant terms from executed vendor contracts. The Vendor Services Intern will be required to assist with reviewing and redlining simple Statements of Work and standard contract terms with management oversight. KEY RESPONSIBILITIES: Review vendor contracts and enter relevant data into Vendor Contract tracking tool Assist with review of Statements of Work, NDAs, and simple amendments File organization of ex ...Read more about Vendor Services - Seasonal Intern - Vendor ServicesMore
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Tulsa, OK, USA ● Req #397Monday, April 15, 2024JOB SUMMARY: Responsible for being the first point of contact for all membership related questions, requests and concerns and for providing outstanding service to our customers. You will answer queries regarding customer benefits, eligibility, PCPs, claims and other questions. You will handle complaints, troubleshoot problems and provide resolutions in a professional and polite manner to ensure first contact resolution and customer satisfaction. The ideal Customer Service Representative will b ...Read more about Customer Service - Customer Service Representative 105-1054More
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Tulsa, OK, USA ● Req #399Monday, April 15, 2024JOB SUMMARY: Responsible for being the first point of contact for all membership related questions, requests and concerns and for providing outstanding service to our customers. You will answer queries regarding customer benefits, eligibility, PCPs, claims and other questions. You will handle complaints, troubleshoot problems and provide resolutions in a professional and polite manner to ensure first contact resolution and customer satisfaction. The ideal Customer Service Representative will b ...Read more about Customer Service - Customer Service Representative 105-1053More
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Tulsa, OK, USA ● Req #476Sunday, April 14, 2024JOB SUMMARY: Responsible for all written inquiries from members seeking resolution through the grievance and appeals process. KEY RESPONSIBILITIES: Researches member issues and prepares grievance and appeals information for each level of the appeal process. Responsible for adhering to established grievance and appeals timeframes. Assures compliance with Federal, State and Accreditation regulations. Receives and responds to member and/or provider written and oral complaints and requests i ...Read more about Quality Improvement - Grievance & Appeals Coordinator 195-1022More
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Tulsa, OK, USA ● Req #430Friday, April 12, 2024JOB SUMMARY: Responsible for being the first point of contact for all membership related questions, requests and concerns and for providing outstanding service to our customers. You will answer queries regarding customer benefits, eligibility, PCPs, claims and other questions. You will handle complaints, troubleshoot problems and provide resolutions in a professional and polite manner to ensure first contact resolution and customer satisfaction. The ideal Customer Service Representative will b ...Read more about Customer Service - Customer Service Representative 105-1016More
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JOB SUMMARY: The Analyst provides analytical support for all departments, including analysis, pricing, capitation, network and provider specific reporting. Analytical support includes creating and executing beginner and intermediate level reports and programs and programming modifications to previously written reports. The Analyst will collaborate with key stakeholders and determine the needed result including any special specifications. The Analyst will work with several databases to pull and ...Read more about Reporting - Health Data Analyst 135-2016More
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Tulsa, OK, USA ● Req #435Wednesday, April 10, 2024JOB SUMMARY: Responsible for being the first point of contact for all membership related questions, requests and concerns and for providing outstanding service to our customers. You will answer queries regarding customer benefits, eligibility, PCPs, claims and other questions. You will handle complaints, troubleshoot problems and provide resolutions in a professional and polite manner to ensure first contact resolution and customer satisfaction. The ideal Customer Service Representative will b ...Read more about Customer Service - Customer Service Representative 105-1064More
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JOB SUMMARY: Provide enterprise-wide system infrastructure support for effective installation/configuration, operation, and maintenance of systems hardware and software. This individual participates in technical research and development to enable continuing innovation within the infrastructure, as well as ensuring that system hardware, operating systems, software systems, and related procedures adhere to organizational values. This individual will assist project teams with technical issues in the ...Read more about Information Technology - Systems AdministratorMore
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Tulsa, OK, USA ● Req #508Tuesday, April 9, 2024JOB SUMMARY: The IT Infrastructure Leader will be a strategic leader responsible for overseeing the design, implementation, and management of our healthcare plan's technology infrastructure. This role requires a seasoned professional with a strong background in IT infrastructure management, a deep understanding of healthcare operations, and the ability to drive technological advancements that align with our business goals. KEY RESPONSIBILITIES: Develop and execute a comprehensive infrastructu ...Read more about Information Technology - Information Technology Infrastructure Leader 130-2057More
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Tulsa, OK, USA ● Req #479Sunday, April 7, 2024JOB SUMMARY: Supports the PMO in project implementations of various enterprise systems including both vendor-provided solutions and applications developed internally. Works directly with business subject matter experts to clearly define project scope, requirements, process flows and other business needs. Communicates effectively with IT and all levels of the organization. KEY RESPONSIBILITIES: Meet with project stakeholders and end users to review, analyze and create detailed documentation ...Read more about Project Management Operations - PMO Analyst 141-2004More
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Tulsa, OK, USA ● Req #419Saturday, April 6, 2024JOB SUMMARY: The Manager of Data Reporting and Risk Adjustment is responsible for directing a team of data analysts in providing analytical support and various cost and quality metrics to both internal and external customers. Facilitates submission of encounter records to regulatory agencies, resolution of rejected records and reconciliations. Facilitates submission of data for CMS and other regulatory audits. Oversees calculation and tracking of risk factors and analyzes trends in risk scores. ...Read more about Reporting - Manager Data Reporting & Risk Adjustment 135-5002More
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JOB SUMMARY: This position is a part of a team that provides support to our sales and retention reps in the form of data gathering, data entry and analysis, proposal and financial exhibit development, and coordinates with internal and external customers to install and renew employer group benefits. KEY RESPONSIBILITIES: Monitor email and respond to Request for Proposals (RFPs): Gather benefit information from a variety of sources, coordinates response, inputs data and maintains all appropria ...Read more about Marketing - Sales & Retention Support 110-1006More
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JOB SUMMARY: This position is a part of a team that provides support to our sales and retention reps in the form of data gathering, data entry and analysis, proposal and financial exhibit development, and coordinates with internal and external customers to install and renew employer group benefits. KEY RESPONSIBILITIES: Monitor email and respond to Request for Proposals (RFPs): Gather benefit information from a variety of sources, coordinates response, inputs data and maintains all appropria ...Read more about Marketing - Sales & Retention Support 110-1001More
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Tulsa, OK, USA ● Req #499Thursday, April 4, 2024JOB SUMMARY: Responsible for selling Medicare products and Individual Health Plan products via telemarketing calls and person-to-person meetings, including seminars. KEY RESPONSIBILITIES: Discuss products and benefits with eligible beneficiaries on a person to person basis in various settings. Makes outbound calls, as allowed, to prospects to answer questions and to schedule further sales follow up calls. Conducts onboarding calls to new enrollees. Conducts disenrollment survey calls. Rece ...Read more about Individual Marketing - Health Plan Consultant 176-1010More
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Tulsa, OK, USA ● Req #504Thursday, April 4, 2024JOB SUMMARY: Responsible for processing reports, reconciling transactions and updating the system. Create and maintain customer eligibility in the company database, generate customer correspondence for new packets, assemble and distribute customer handbooks and process notifications. KEY RESPONSIBILITIES: Create and maintain customer eligibility in the database. Generate appropriate correspondence and ID cards. Review and process files and reports. Mail customer notices and requests for ...Read more about Enrollment Services - Enrollment Specialist 160-1003More
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JOB SUMMARY: This position is a part of a team that provides support to our sales and retention reps in the form of data gathering, data entry and analysis, proposal and financial exhibit development, and coordinates with internal and external customers to install and renew employer group benefits. KEY RESPONSIBILITIES: Monitor email and respond to Request for Proposals (RFPs): Gather benefit information from a variety of sources, coordinates response, inputs data and maintains all appropria ...Read more about Marketing - Sales & Retention Support 110-1003More
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Tulsa, OK, USA ● Req #475Thursday, April 4, 2024JOB SUMMARY: Responsible for providing technical and customer service support for pharmacy benefits, processing prior authorizations according to CMS and State regulations, and resolving pharmacy related complaints. KEY RESPONSIBILITIES: Telephone support for pharmacies and members related to pharmacy benefits for the HMO product. Provides resolution for various types of phone calls including, but not limited to referral, authorization, and step therapy protocols between physicians, pharmac ...Read more about Pharmacy - Pharmacy Technical Support Specialist 146-1031More
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Tulsa, OK, USA ● Req #497Tuesday, April 2, 2024JOB SUMMARY: Responsible for selling Medicare products and Individual Health Plan products via telemarketing calls and person-to-person meetings, including seminars. KEY RESPONSIBILITIES: Discuss products and benefits with eligible beneficiaries on a person to person basis in various settings. Makes outbound calls, as allowed, to prospects to answer questions and to schedule further sales follow up calls. Receives inbound calls from prospective enrollees, answer questions about company pr ...Read more about Individual Marketing - Health Plan Consultant 176-1008More
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Tulsa, OK, USA ● Req #483Tuesday, April 2, 2024JOB SUMMARY: Responsible for the review, analysis, reporting and follow-up of risk adjustment and clinical coding functions to support the accurate representation of the member’s clinical health status as well as the accuracy of internal systems to support clinical decisions. This role works collaboratively with multiple internal departments as well as with external providers. KEY RESPONSIBILITIES: Serve as clinical coding resource across the CommunityCare Health Network Division in suppor ...Read more about Quality Improvement - Clinical Coding & Compliance Analyst 195-2013More
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JOB SUMMARY: Responsible for training of all non-exempt personnel in the Claims, Enrollment, and Customer Service departments on procedures, policies, and mode of operations. This will be done by directly delivering content, developing content for learning, arranging for specialists to deliver content and by measuring the progress of the new hire. The trainer will also assist current employees with residual training needs or training on new processes, procedures or products. KEY RESPONSIBIL ...Read more about Training - Trainer 103-1004More
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JOB SUMMARY: Responsible for marketing the company’s commercial products to prospective clients and for assisting in the servicing and retaining existing accounts. KEY RESPONSIBILITIES: Identifies and sells lines of business directly to potential corporate clients and through an assigned distribution of agents/brokers. Group market includes an emphasis on small and large group market. Must comply with provisions contained within the Sales Compensation Program. Identifies new opportunities w ...Read more about Marketing - Account Executive 110-2002More
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Tulsa, OK, USA ● Req #457Tuesday, March 26, 2024JOB SUMMARY: Responsible for conducting clinical behavioral health assessments and/or brief counseling of clients. Make referrals and conducts referral assessments, and follow-up. Provide training and/or workshops to EAP companies. KEY RESPONSIBILITIES: Conducts clinical behavioral health assessments and/or brief counseling of clients and makes referrals to contracted providers for select diagnoses. Monitor and manage affiliate cases to insure appropriate utilization of the EAP. Conducts ...Read more about Employee Assistance Program - EAP Counselor 151-2004More
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JOB SUMMARY: The pharmacy intern will provide support to the CommunityCare Pharmacy Department by participating in Medicare Stars, Medication Adherence, and Medication Therapy Management Programs. This position will also provide clinical support for Pharmacy & Therapeutics, Prior Authorizations, and other clinical reviews and research as needed. Effective communication is an important part of this role. The position will be interacting with members, providers, and other departments within Commu ...Read more about Pharmacy- Seasonal Intern - PharmacyMore
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Tulsa, OK, USA ● Req #331Monday, March 25, 2024JOB SUMMARY: The Manager of Data Reporting and Report Development is responsible for architecting advanced data solutions while directing a team of data analysts in providing analytical, operational, cost and quality metrics to both internal and external customers, including regulatory reporting to CMS. This role acts as the Architect of data warehouse data marts and self-service reporting platform solutions. Additionally, this role supervises and manages both a team of health data analysts, ...Read more about Reporting - Manager Data Reporting & Report Development 135-5003More
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Tulsa, OK, USA ● Req #485Thursday, March 21, 2024JOB SUMMARY: Primarily responsible for contracting, orientation and ongoing education of physicians, physician office staffs, hospitals and other providers regarding the policies and procedures of CommunityCare Managed HealthCare Plans. Serves as the liaison between the provider community and the health plan. KEY RESPONSIBILITIES: Conducts educational and credentialing PCP and appropriate SCP office site visits according to established standards. Provides ongoing education, develops agendas, ...Read more about Provider Services - Provider Services Representative 115-1005More