operations of CommunityCare’s medical claim review program. The Supervisor guides individuals in implementing auditing...
in accordance with federal and state mandates, and credentialing criteria as outlined in the CommunityCare Managed Healthcare Plans...
outreach, exceptional service, and personalized support. The Retention Specialist helps CommunityCare achieve membership growth... events to ensure members are fully informed about CommunityCare benefits and offerings. Contact at-risk members...
established by CommunityCare Managed Healthcare Plans of Oklahoma. Processes may include communication with provider...
understanding and sensitivity to the unique needs of the CommunityCare population. This role spends 100% of time on quality program...
CommunityCare brand and mission to broker partners (broker agencies, agents and FMOs), contracted providers/health systems..., community leaders and organizations through CommunityCare in person events, health fairs, social and digital marketing...
JOB SUMMARY: The Member Advocate I serves as a liaison between members and CommunityCare, ensuring a high-quality... need support with navigating their CommunityCare health plan. Assist members in understanding their benefits, claims...
operations of CommunityCare’s medical claim review program. The Supervisor guides individuals in implementing auditing...
and requests in accordance with CommunityCare's grievance and appeals procedures. Ensures appropriate file documentation...
and Responsibilities: Perform other special projects and duties as assigned by the executive staff of CommunityCare Managed Healthcare...
the CommunityCare brand and mission to broker partners (broker agencies, agents and FMOs), contracted providers/health... systems, community leaders and organizations through CommunityCare in person events, health fairs, social and digital...
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 mem...
JOB SUMMARY: The Technical Product Owner (TPO) serves as the bridge between business needs and technical implementation, ensuring that product development aligns with strategic objectives and delivers measurable value. The TPO partners cl...
JOB SUMMARY: The Technical Product Owner (TPO) serves as the bridge between business needs and technical implementation, ensuring that product development aligns with strategic objectives and delivers measurable value. The TPO partners cl...
JOB SUMMARY: Responsible for providing daily guidance, instruction and training to inspire the team to perform at their optimum. Will work directly with Customer Service Supervisor to create a team that works efficiently together to maxim...
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 an...
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 mem...
JOB SUMMARY: The Employee Engagement Coordinator plays a critical role in fostering a positive and productive workplace culture by planning, implementing, and evaluating employee engagement programs and initiatives to increase employee en...
JOB SUMMARY: The Enterprise Data Architect provides strategic and technical leadership for the design, governance, and evolution of the organization’s enterprise data ecosystem. This role serves as the senior authority on data architectur...
JOB 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 be...