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  • Tulsa, OK, USA ● Req #334
    Wednesday, September 27, 2023
    JOB 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 ... More
  • Tulsa, OK, USA ● Req #331
    Wednesday, September 27, 2023
      JOB 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, ... More
  • Tulsa, OK, USA ● Req #332
    Wednesday, September 27, 2023
    JOB SUMMARY: The Data Engineer II will be responsible for expanding and optimizing our data and data pipeline architecture, as well as optimizing data flow and collection across organizational teams. The Data Engineer will support our software engineers, database architects and data analysts on data initiatives and will ensure optimal data delivery architecture is consistent throughout ongoing projects. KEY RESPONSIBILITIES: •Create and maintain optimal data pipeline architecture to support o ... More
  • Tulsa, OK, USA ● Req #337
    Wednesday, September 27, 2023
    JOB SUMMARY: Responsibleformaintaining information related to Accounts Receivable, Broker Commissions and Daily Deposits. KEY RESPONSIBILITIES: Performs all A/R duties related to Broker Commissions for Commercial HMO, CCLH and Medicare including checking the calculations, updating Great Plains and the Access database, and mailing commissions and statements. Act as backup for Commercial deposits; to include research and posting in all systems. Creates and maintains Great Plains Commercial Sale ... More
  • Tulsa, OK, USA ● Req #356
    Sunday, September 24, 2023
    JOB SUMMARY: As the CRM Administrator for CommunityCare, you will develop and maintain the CRM systems. In this role, you will monitor end-user usage of the system, perform daily administrative and user support tasks, and help solve business problems. You will partner with product owners to define system requirements, and build, configure, and automate technology solutions to deliver business value. KEY RESPONSIBILITIES: Serve as a system administrator collaborating with the product owner, han ... More
  • Tulsa, OK, USA ● Req #360
    Sunday, September 24, 2023
    JOB SUMMARY: The Software Engineer will build out the next generation of our platform. As a Software Engineer, you are expected to work independently, and within teams, leading the development of software features. You will be involved with the early stages of mentoring other team members and helping with identifying process improvements for the team. KEY RESPONSIBILITIES: •Implements features of the application and is proficient in one or more of the feature or components. •Leads independent ... More
  • Tulsa, OK, USA ● Req #361
    Sunday, September 24, 2023
    JOB SUMMARY: The Claims Examiner is responsible for examining claims that require review prior to being adjudicated.The examiner will use their resources, knowledge and decision-making acumen to determine the appropriate actions to pay, deny or adjust the claim. Examiners are expected to meet performance expectations in accuracy and efficiency. KEY RESPONSIBILITIES: Examining and adjudicating claims that have pended for review utilizing resources, tools, knowledge and decision-making in deter ... More
  • Tulsa, OK, USA ● Req #359
    Sunday, September 24, 2023
    JOB SUMMARY: Responsible for helping CommunityCare achieve membership growth targets by meeting or exceeding goal levels for the retention of enrolled groups and members. The incumbent is responsible for establishing positive business relationships with decision makers and decision influencers at enrolled groups, as well as with producers and consultants associated with enrolled groups. KEY RESPONSIBILITIES: Establishing positive business relationships with strategic decision makers and influe ... More
  • Tulsa, OK, USA ● Req #34
    Sunday, September 24, 2023
    JOB SUMMARY: Responsible for clinical review of services requiring medical authorization and documentation of decisions and clinical information. This role practices independent judgement using clinical knowledge prioritizing cases based upon medical necessity and regulatory guidelines. In addition, uses discretion with everyday confidentiality preserving patient cases.  KEY RESPONSIBILITIES: Reviews requests for services (inpatient, ancillary, and outpatient). Makes decisions according to guide ... More
  • Tulsa, OK, USA ● Req #204
    Saturday, September 23, 2023
    JOB SUMMARY: The Sr. Software Engineer will build out the next generation of our platform. As a Sr. Software Engineer, you are expected to work independently, and within teams, leading the development of software features. Ability to prioritize well, communicate clearly, have a consistent track record of delivery, and excellent software engineering skills. You will be involved with mentoring other team members and helping with identifying process improvements for the team. KEY RESPONSIBILITIES:D ... More
  • Tulsa, OK, USA ● Req #206
    Saturday, September 23, 2023
    JOB SUMMARY:  The Software Engineer II will build out the next generation of our platform. As a Software Engineer II, you are expected to work independently, and within teams, leading the development of software features. You will be involved with the early stages of mentoring other team members and helping with identifying process improvements for the team.KEY RESPONSIBILITIES: Implements features of the application and is proficient in one or more of the feature or components. Leads independen ... More
  • Tulsa, OK, USA ● Req #225
    Friday, September 22, 2023
    Job Summary:  Responsible for all aspects of the G&A. Prepare quarterly and annual filings and financial statements. Analyzes account activity and provides information to management.  Responsibilities: Assist in the coordination and preparation of the Company’s financial statements and reports for internal distribution and regulatory filings. Assist in the coordination and preparation of the Company’s quarterly and annual filings required by National and State agencies. Prepare and record asset, ... More
  • Tulsa, OK, USA ● Req #378
    Thursday, September 21, 2023
    JOB SUMMARY: Responsible for Marketing Department implementation and coordination of group activity collaborate with key players to ensure each project gets the resources and attention needed to be successful. Responsible for handling correspondence with clients and communicating with other departments within the company to keep marketing campaigns on track. KEY RESPONSIBILITIES: Responsible for tracking relevant activity in applicable database. Compiles and prepares various reports for key ... More
  • Tulsa, OK, USA ● Req #377
    Thursday, September 21, 2023
    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 RESPONSIBILITIES ... More
  • Tulsa, OK, USA ● Req #375
    Thursday, September 21, 2023
    JOB 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 ... More
  • Tulsa, OK, USA ● Req #374
    Thursday, September 21, 2023
    JOB 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 ... More
  • Tulsa, OK, USA ● Req #266
    Saturday, September 16, 2023
    JOB SUMMARY: This non-clinical position supports the department by performing a broad range of clerical duties. KEY RESPONSIBILITIES: Prepares correspondence to members, providers, and facilities. Provides follow up with providers and members as needed. Reviews service requests for completeness of information. Enters information into the database, compiles data and runs reports. Receives telephone calls, answers non-clinical questions and takes information, or refers callers to appropriate par ... More
  • Tulsa, OK, USA ● Req #372
    Friday, September 15, 2023
    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 with ... More
  • Tulsa, OK, USA ● Req #34
    Friday, September 15, 2023
    JOB SUMMARY: Responsible for clinical review of services requiring medical authorization and documentation of decisions and clinical information. This role practices independent judgement using clinical knowledge prioritizing cases based upon medical necessity and regulatory guidelines. In addition, uses discretion with everyday confidentiality preserving patient cases.  KEY RESPONSIBILITIES: Reviews requests for services (inpatient, ancillary, and outpatient). Makes decisions according to guide ... More
  • Tulsa, OK, USA ● Req #33
    Friday, September 15, 2023
    JOB SUMMARY: Responsible for working with members, providers, and other multidisciplinary team members to facilitate, collaborate and coordinate healthcare for members identified with complex healthcare needs. Work with members throughout the continuum of care to enhance the members healthcare experience and assist with the provision of cost-effective healthcare options. KEY RESPONSIBILITIES: Complete clinical assessments of members requiring case management oversite to assist with facilitation ... More
  • Tulsa, OK, USA ● Req #32
    Friday, September 15, 2023
    JOB SUMMARY: Responsible for working with members, providers, and other multidisciplinary team members to facilitate, collaborate and coordinate healthcare for members identified with complex healthcare needs. Work with members throughout the continuum of care to enhance the members healthcare experience and assist with the provision of cost-effective healthcare options. KEY RESPONSIBILITIES: Complete clinical assessments of members requiring case management oversite to assist with facilitation ... More
  • Tulsa, OK, USA ● Req #283
    Thursday, September 14, 2023
    JOB SUMMARY: Responsible for working with members, providers, and other multidisciplinary team members to facilitate, collaborate and coordinate healthcare for members identified with complex healthcare needs.   Work with members throughout the continuum of care to enhance the members healthcare experience and assist with the provision of cost-effective healthcare options.   KEY RESPONSIBILITIES: Complete clinical assessments of members requiring case management oversite to assist with ... More
  • Tulsa, OK, USA ● Req #349
    Saturday, September 9, 2023
    JOB SUMMARY: This non-clinical position supports the department by performing a broad range of clerical duties. KEY RESPONSIBILITIES: Prepares correspondence to members, providers, and facilities. Provides follow up with providers and members as needed. Reviews service requests for completeness of information. Enters information into the database, compiles data and runs reports. Receives telephone calls, answers non-clinical questions and takes information, or refers callers to appropriate par ... More
  • Tulsa, OK, USA ● Req #350
    Saturday, September 9, 2023
    JOB SUMMARY: This role is an Atlassian Business Analyst focused on building out a new JIRA ITSM environment and automation. The Administrator will be working with the team members to roll out changes to our infrastructure.   KEY RESPONSIBILITIES: Create comprehensive JIRA workflows including project workflows, screen schemes, permission schemes, notification schemes etc. Build customized solutions to extend the functionality of Atlassian JIRA using third party add-ons. Set up reports, dashboard ... More
  • Tulsa, OK, USA ● Req #368
    Thursday, September 7, 2023
    JOB 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 in acco ... More