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  • Tulsa, OK, USA ● Req #789
    Tuesday, April 15, 2025
    JOB SUMMARY: Responsible for providing assistance to Executive Level Officer(s) on all scheduling, travel arrangements, meeting preparation, report compilations and special projects. Provides administrative support including all private correspondence, and maintaining confidential files and records forExecutive Level Officer(s).     KEY RESPONSIBILITIES: Schedules, coordinates and organizes various meetings for Executive Level Officer(s).   Transcribes and prepares correspondence, memorandums, ... More
  • Tulsa, OK, USA ● Req #721
    Sunday, April 13, 2025
    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. Must be willing to learn and grow into roles of increasing responsibility.   KEY RESPONSIBILITIES: Establishi ... More
  • Tulsa, OK, USA ● Req #791
    Thursday, April 10, 2025
    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 ... More
  • Tulsa, OK, USA ● Req #790
    Wednesday, April 9, 2025
    JOB SUMMARY: The Health Risk Assessment Coordinator is responsible for ensuring completion of a health risk survey for all newly enrolled Medicare and Individual Marketplace members. Responsibilities include identifying health risks scores, generating reports and distributing data to the responsible departments. This role supports the QI team member outreach activities including education for Medicare and Commercial members.  This role spends 100% of time on quality program activities.   KEY RES ... More
  • Tulsa, OK, USA ● Req #796
    Tuesday, April 8, 2025
    JOB SUMMARY: Supports the Company in the development and execution of business strategies through detailed research, data analysis, and strategic recommendations. This individual will work closely with cross-functional teams to assess market opportunities and competitive performance. The ideal candidate will possess strong analytical skills and the ability to effectively communicate insights to key stakeholders.   KEY RESPONSIBILITIES: Develop financial models and forecasts to project the impac ... More
  • Tulsa, OK, USA ● Req #777
    Monday, April 7, 2025
    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 ... More
  • Tulsa, OK, USA ● Req #792
    Monday, April 7, 2025
    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 ... More
  • Tulsa, OK, USA ● Req #787
    Monday, April 7, 2025
    JOB SUMMARY: Responsible for planning, developing, and coordinating Senior Center activities, and Senior Center Customer Services. Manage Member Advocates, Medicare/HAP Coordinator, SHP Volunteers and oversee the Volunteer Program. Scheduling and coordination of conference room activities for Medicare programs, enrollment, and Healthcare Reform as well as other meetings.   KEY RESPONSIBILITIES: Manage Member Advocates, Medicare/HAP Coordinator, part-time employees and volunteers. Oversee the as ... More
  • Tulsa, OK, USA ● Req #794
    Monday, April 7, 2025
    The Compensation Analyst is responsible for supporting the development, implementation, and maintenance of the company's compensation programs. This role involves conducting market analysis, administering salary structures, preparing compensation reports, and ensuring compliance with federal, state, and local compensation regulations. The Compensation Analyst works closely with the Director of Human Resources to ensure competitive and equitable pay practices across the organization.   KEY RESPON ... More
  • Tulsa, OK, USA ● Req #788
    Monday, April 7, 2025
    JOB 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, ... More
  • Tulsa, OK, USA ● Req #785
    Monday, April 7, 2025
    JOB SUMMARY:  Responsible for maintaining and supporting the Help Desk and new systems including network installations, personal computers support and maintenance, and infrastructure development.    KEY RESPONSIBILITIES:  Maintain help desk.   Perform network administration including the installation and configuration of new personal computers.   Research new technologies and developmental tools and recommend their implementation.  Provide support to users in the resolution of ... More
  • Tulsa, OK, USA ● Req #782
    Monday, April 7, 2025
    JOB SUMMARY: Responsibilities include performing credentialing activities consistently for each applicant in accordance with federal and state mandates, and credentialing criteria as outlined in the CommunityCare Managed Healthcare Plans of Oklahoma Policy and Procedure Manual.   KEY RESPONSIBILITIES: Responsible for initial assessment of applications and other data for accuracy and completeness and contacting applicants or other outside resources to resolve questions or to obtain missing inf ... More
  • Tulsa, OK, USA ● Req #778
    Monday, April 7, 2025
    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 ... More
  • Tulsa, OK, USA ● Req #786
    Tuesday, April 1, 2025
    JOB SUMMARY: Plans, organizes, manages, and leads the activities of various operational functions of the company including Finance, Underwriting, Financial Analysis, Investments, and Reporting. Significant emphasis of this role surrounds financial reporting and analysis of budgeting, accounting, financial systems development, internal controls, and maintenance of records and procedures to adequately safeguard the assets of the organization. The CFO will provide financial leadership and directio ... More
  • Tulsa, OK, USA ● Req #641
    Monday, March 31, 2025
    JOB SUMMARY: Responsible for supervising credentialing personnel and oversight of training. Supervise workflows and projects to support timely, efficient production. Responsible for ensuring credentialing policies and procedures are compliant with regulatory agencies and accreditation standards.   KEY RESPONSIBILITIES: Provide day-to-day supervision of personnel. Evaluate performance of direct reports and provide regular feedback individually and to the team.Identify improvement opportunities t ... More
  • Tulsa, OK, USA ● Req #575
    Monday, March 31, 2025
    JOB SUMMARY: The Senior Health Data Analyst provides the analytical support for Executives and all departments including analysis, pricing, capitation, network, and provider specific reporting. Analytical support includes programming customer-based specifications, producing appropriate statistics, reports, and presentations, analyzing results and impacts, and generating written reports with recommendations and conclusions. The Senior Analyst works with data in company and other databases, data ... More
  • Tulsa, OK, USA ● Req #751
    Friday, March 21, 2025
    JOB SUMMARY: The Quality Improvement Stars Specialist is an integral part of the team, focusing on enhancing the performance of quality programs.  This role requires a proactive individual who is adept at working collaboratively with provider groups and multidisciplinary teams with minimal oversight to ensure adherence to deadlines and compliance with regulatory requirements.  The specialist will play a pivotal role in the analysis, development, and implementation of strategies aimed at improvin ... More
  • Tulsa, OK, USA ● Req #772
    Wednesday, March 19, 2025
    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 ... More
  • Tulsa, OK, USA ● Req #775
    Tuesday, March 18, 2025
    JOB SUMMARY: Responsible for clinical review of utilization requests and assessment and implementation of potential coordination of care opportunities for overall membership, institutionalized populations, high risk members, and other members identified with at risk or high utilization needs. Functions as an active team member of the Concurrent Review Team.   KEY RESPONSIBILITIES: Performs utilization review of inpatient, post-acute, outpatient and ancillary services. Determines medical neces ... More
  • Tulsa, OK, USA ● Req #776
    Tuesday, March 18, 2025
    JOB SUMMARY: Responsible for clinical review of utilization requests and assessment and implementation of potential coordination of care opportunities for overall membership, institutionalized populations, high risk members, and other members identified with at risk or high utilization needs. Functions as an active team member of the Concurrent Review Team.   KEY RESPONSIBILITIES: Performs utilization review of inpatient, post-acute, outpatient and ancillary services. Determines medical neces ... More
  • Tulsa, OK, USA ● Req #762
    Tuesday, March 18, 2025
    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 areas of risk and/or potential fraud, waste and abuse, as it relates to provider billing practices. KEY RESPONSIBILITIES: Provides technical expertise to Medical Review (MRE) staff including analysis, problem solving, and ... More
  • Tulsa, OK, USA ● Req #761
    Tuesday, March 18, 2025
    JOB SUMMARY: Focus on the development and support of new and existing Database Management Systems (DBMS). Responsible for the design, development and implementation of new applications as well as maintaining and updating existing programs.   KEY RESPONSIBILITIES: Perform Oracle DBA Functions Design and analysis of critical Database Management Systems (DBMS) related to the AMISYS systems and surround code programs. Design, code, test, maintain and document structured desktop and web programs u ... More
  • Tulsa, OK, USA ● Req #765
    Tuesday, March 18, 2025
    JOB SUMMARY: Responsible for the negotiation, execution and implementation of all HMO, PPO and Government Programs, provider contracts including value based and complex. Responsible for the supervision (planning, execution, implementing and monitoring) of all aspects of the provider contracting staff. Responsible for contract related processes and procedures under the direction of the Director, Provider Relations. Responsible for ensuring provider contracting is performed in compliance with all ... More
  • Tulsa, OK, USA ● Req #764
    Tuesday, March 18, 2025
    JOB SUMMARY: Responsible for providing customer service support for behavioral health benefits, directing members to appropriate in network services, processing prior authorizations according to CMS and State regulations, sending out provider faxes well as member letters, and resolving behavioral health related situations that arise from calls. KEY RESPONSIBILITIES: Available and able to be telephone support from 8AM -5PM except for lunch and breaks to support behavioral health needs for all ... More
  • Tulsa, OK, USA ● Req #766
    Tuesday, March 18, 2025
    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 ... More