Medical Management - Supervisor Medical Review 145-4005 - Tulsa

The Medical Review Officer (MRO) shall be a licensed physician, M.D. or D.O., who is knowledgeable about the following: Controlled substances abuse disorders, including knowledge of alternative medical explanations for laboratory confirmed drug test results, issues relating to ad ...

HireRight is the premier global background screening and workforce solutions provider. We bring clarity and confidence to vetting and hiring decisions through integrated tailored solutions driving a higher standard of accuracy in everything we do. Combining in-house talent person ...

This position is responsible for pre-authorization reviews in accordance with the medical contract and regulations, medical criteria, utilization review, · and quality of care.LPN with valid current unrestricted clinical license in the state of operations. · 3 years of clinical e ...

HireRight is a global background screening and workforce solutions provider. We bring clarity and confidence to vetting and hiring decisions through integrated, tailored solutions. · ...

The Medical Review Supervisor oversees day-to-day operations of CommunityCare's medical claim review program. They guide individuals in implementing auditing and monitoring functions to identify areas of risk and/or potential fraud, · waste and abuse related to provider billing p ...

The Medical Review Supervisor is responsible for overseeing activities and personnel involved in the day to day operations of CommunityCare's medical claim review program. The Supervisor guides individuals in implementing auditing and monitoring functions aimed at identifying are ...

The Medical Review Examiner Nurse is responsible for auditing provider and facility claims. Identifying issues related to and/or participates in various projects aimed at identifying areas of non-compliance and/or potential fraud, waste and abuse, as it relates to provider billin ...

The Medical Review Officer shall be a licensed physician, M.D. or D.O., who is knowledgeable about controlled substances abuse disorders. · ...

The Medical Review Officer (MRO) shall be a licensed physician, M.D. or D.O., who is knowledgeable about the following: Controlled substances abuse disorders, including knowledge of alternative medical explanations for laboratory confirmed drug test results. · ...

Dane Street is expanding our physician panel We are seeking a skilled and board-certified Diagnostic Radiologist to join our team for Independent Medical Record Reviews. This is a fully remote opportunity offering flexible scheduling, allowing you to accept or decline cases based ...

The Medical Director provides physician-level clinical review expertise within the health plan's utilization management... · ...

Dane Street wants you to join our dynamic team of expert reviewers In this role, you will have the opportunity to utilize your medical expertise to conduct thorough reviews of clinical cases. · This telework opportunity allows you to customize your schedule as a 1099 independent ...

Magnet Medical is seeking a travel Ultrasound Technologist for a travel job in Tulsa, Oklahoma. · Job Description & Requirements · Specialty: Ultrasound Technologist · Discipline: Allied Health Professional · Start Date: 03/30/2026 · Duration: 13 weeks · 40 hours per week · Shift ...

Dane Street wants you to join our dynamic team of expert reviewers In this role, you will have the opportunity to utilize your medical expertise to conduct thorough reviews of clinical cases. · This telework opportunity allows you to customize your schedule as a 1099 independent ...

Dane Street wants you to join our dynamic team of expert reviewers In this role, you will have the opportunity to utilize your medical expertise to conduct thorough reviews of clinical cases. · This telework opportunity allows you to customize your schedule as a 1099 independent ...

Plans pharmacy activities. Prepares reports and budgets. · Reviews physician medication orders. · ...

GQR Healthcare is seeking a travel nurse RN Utilization Review for a travel nursing job in Baltimore, Maryland. · Job Description & Requirements · Specialty: · Utilization Review · Discipline: · RN · Duration: · 13 weeks · 40 hours per week · Shift: · 8 hours, days · Employment T ...

We are seeking a highly organized and detail-oriented Insurance Verification Representative to join our team. · Verify insurance benefits and eligibility to ensure accurate billing and claims submission. · ,Contact insurance companies to obtain prior authorizations for medical pr ...

JOB SUMMARY: · The Medical Director provides physician-level clinical review expertise within the health plan's utilization management, appeals, and clinical governance programs. The Medical Director applies evidence-based clinical judgment to utilization management and appeal de ...

Job Title: Pharmacy Manager · Position Type: Direct Hire · Location: Tulsa, OK 74133 · Shift/Schedule Details: Monday–Friday, 8:00 AM–4:00 PM · Incentives (Sign-on Bonus / Relocation): Possible relocation for eligible candidates · Additional Notes (if any): Lead pharmacy operati ...