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Jenks Public Schools

Clock and Scorebook Keeper

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: Reviews, interprets and summarizes proposed and enacted legislation and regulatory updates to the business as a subject matter expert on various complex topics. Performs state or federal policy research and regulatory change monitoring with a goal of achieving formal regulatory approval of commercial/Marketplace products.<ul> <li>Identifies, analyzes and interprets proposed or enacted legislation related to Centene's commercial product at the federal and state level and communicates findings to impacted departments. Independently performs risk assessments, including impact to business applications and downstream output. Maintains database and other reference materials related to legislative and regulatory issues and compliance.</li> <li>Performs comprehensive, complex regulatory analyzes, including the review, summarization and dissemination of key regulatory updates and changes related to Commercial/ACA rules and regulations at the state and/or federal level. Leads regulatory interpretation related to Commercial/ACA Rules and regulations and the commercial product explaining concepts clearly and adapting language and presentation based on audience level. Provides advice to business as new regulations emerge.</li> <li>Uses persuasive arguments and secures cooperation from the business in order to address potential legal, contractual and/or regulatory issues. Ability to determine appropriate approach for solving regulatory problems.</li> <li>Develops trust-based relationships within varied audiences and collaborates with other functional areas to lead large projects and initiatives. Attends cross-departmental meetings as department representative, provides guidance to the business related to commercial regulatory requirements and appropriately escalates matters to management. Solutions to address potential legal, contractual and/or regulatory issues which arise working closely with Legal and Compliance.</li> <li>Support and manage relationships between health plans and regulatory agencies, including state and federal regulators. Independently drafts responses to external requests for information required by the organization for its regulatory filings and/or for policy needs.</li> <li>Responsibility for understanding regulations and business needs for multiple states, as well as federal regulations pertaining to the commercial health insurance market.</li> <li>Assesses and analyzes objections related to regulatory interpretation and leads drafting of appropriate responses which are provided to regulators related to commercial/ACA filings. Partners on response with cross-functional partners as needed.</li> <li>Leads the research and regulatory guardrails for new state entry and new product development, working closely with legal on preparation of COA application materials/submissions for new states and/or products.</li> <li>Assists in developing and mentorship of junior employees, supporting creation and revisions to training materials. May attend external and/or virtual conferences and seminars to evaluate industry trends.</li> <li>May attend external and/or virtual conferences and seminars to evaluate industry trends.</li> <li>Performs other duties as assigned</li> <li>Complies with all policies and standards</li> </ul>Education/Experience: Bachelor's Degree in Business, Communications, Healthcare, Political Science/Pre-Law or equivalent experience required: Master's Degree in a related field, Juris Doctorate degree may be considered in place of experience preferred. 4+ years experience in health insurance, legal, compliance or related field required. Experience reviewing regulations and providing interpretation using terms appropriate for the audience preferred. Experience in commercial health insurance and/or behavioral health managed care preferred. Please note: this is a remote position with Central Time (CT) work hours.Pay Range: $68,700.00 - $123,700.00 per yearCentene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law. Total compensation may also include additional forms of incentives.Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

Oklahoma Complete Health

Regulatory Operations Analyst III

<ul> <li> </li> </ul> We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class. FOLLOW US <h4>ARDENT HEALTH SERVICES</h4> Ardent Health Services invests in quality health care. In people, technology, facilities and communities, Ardent makes considerable investments – producing high quality care and extraordinary results. <h4>CONTACT US</h4> One Burton Hills Blvd. Suite 250 Nashville, TN 37215 (615) 296-3000 We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class. Copyright © Ardent Health Services. All rights reserved. Here is the google script and the instructions: Paste this code as high in the of the page as possible: Additionally, paste this code immediately after the opening tag:

Utica Park Clinic

Employed Endocrinology Opening | Oklahoma Heart Institute | Tulsa, OK

Speech and Language Pathology Assistant

Overview Responsible for being the clinical expert in the delivery of quality, effective patient care through the management and oversight of company clinical resources, processes, and outcomes. This role is also responsible for the assurance of compliance with local, state, federal and accreditation standards for all care centers within an assigned geographical area. Responsibilities <ol> <li>Supervises all aspects of the hospice clinical program within assigned POD.</li> <li>Serves as the territory clinical leader, both internally and externally facing, and collaborates extensively with POD leadership team (Area Vice President Operations and Area Vice President of Business Development) to ensure operational excellence.</li> <li>Reviews care center quality measures monthly with care center and POD leadership to develop and analyze indicators identifying trends in the delivery of care and clinical operation efficiencies. Provides guidance and direction for care center management and staff on matters affecting the delivery of services to patients. Creates, implements, and monitors performance improvement activities at the care center and POD level to drive clinical operations and quality metrics to and above the baseline of state/ federal/company scores.</li> <li>Ensures that corporate and regional clinical initiatives are implemented, outcomes monitored, and education provided to care center leadership, clinicians, and business development partners, as applicable, including the supervision of specialty programs.</li> <li>Performs comprehensive assessments and analysis of clinical process management in the care center and in delivery of patient care. Provides education on company policy, clinical processes, and procedures as well as follow-up to validate timely resolution of action items.</li> <li>Directs and oversees clinical process improvement methods, provides direction for care center staff, assists care center leadership in the development of corrective action plans and provides education for care center leadership in the implementation of processes.</li> <li>Provides support, direction, and feedback to staff during the clinical and compliance processes.</li> <li>Communicates with corporate Compliance regarding any reportable findings or issues identified in a care center that would potentially put a patient or the company at risk.</li> <li>Facilitates education based on care center and region assessment findings.</li> <li>Partners with Area Vice President of Operations to adjustment clinical operations, expenses, and staffing to address needs in quality improvement and fiscal metrics. Reviews with care center leadership and drives improvement of clinical aspects of documentation requirements and the reimbursement process.</li> <li>Serves as an expert resource to the care center and region leadership regarding Medicare conditions of participation, company policy, and Medicare management including providing support, direction, oversight for care centers to ensure proper and timely follow up during state/ accreditation surveys, internal surveys, ADR/TPE requests, as well as implementation of clinical and compliance processes.</li> <li>Supervises care center clinical competency including on-boarding expectations including, but not limited to, clinical orientation of Director of Operators and Clinical Managers. Provides assistance/oversight for care center clinician orientation, as needed. Works with the corporate and regional leadership in identifying opportunities for additional or needed training and provides it.</li> <li>Participates in the interview process for all clinical and care center leadership positions, as needed. Monitors and evaluates care center leadership performance. Holds leadership accountable for the attainment of defined goals and objectives. Executes effective performance redirection when needed.</li> </ol> <ol> <li>Develops leaders through coaching, mentoring, and formal/on the job training and development opportunities.</li> <li>Directs and oversees quarterly quality assurance / performance improvement (QAPI) activities with communication to care center and region leadership and acts as a resource regarding policy interpretation, process improvement and follow-up actions required.</li> <li>Provides oversight and tracking of LLOS Bill to ensure proper and timely follow-up.</li> <li>Performs other duties as assigned.</li> </ol> Knowledge, Skills and Abilities: <ul> <li>Experience with state/CMS Survey Process.</li> <li>Experience with use of Homecare Homebase and Electronic Medical Record.</li> </ul> Qualifications Required <ul> <li> Current, unencumbered license to practice as Registered Nurse. An employee in this role is only able to provide clinical guidance to patients in states in which the employee possesses a current, unencumbered license. May possess either a single state license in each non-compact state and/or a compact license in their state of residence that is accepted in all Nurse License Compact (NLC) participating states.<ul><li>Nurse Licensure Compact (NLC) documents the following: The mutual recognition model of nurse licensure allows a nurse to have one license (in his or her state of residency) and to practice in other states (both physical and electronic), subject to each state's practice law and regulation. Nurses must legally reside in a NLC state to be eligible to have a multi-state license. See list of Nurse Licensure Compact (NLC)</li></ul> </li> <li>Five (5+) years clinical experience; at least three (3+) years in a management/supervisory capacity in Home Health or Hospice industry.</li> </ul> Amedisys is an equal opportunity employer. All qualified employees and applicants will receive consideration for employment without regard to race, color, religion, sex, age, pregnancy, marital status, national origin, citizenship status, disability, military status, sexual orientation, genetic predisposition or carrier status or any other legally protected characteristic.

Amedisys

SS HSP AVP Clinical

At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers.Join HCSC and be part of a purpose-driven company that will invest in your professional development.<h1>Job Summary</h1>This position is responsible for assigned aspects of edical policies and programs. Performs medical reviews and interacts with the provider communities for assigned areas.JOB REQUIREMENTS:. * Physician (M.D. or D.O) with a current and unrestricted physician license in a the state of Oklahoma. * Maintain Board Certification by a specialty board approved by the American Board of Medical Specialties, National Board of Physicians and Surgeons, or the Advisory Board of Osteopathic Specialists * 5 years of clinical experience * Analytical and communication skills * Strategic thinking skills * Proficiency in computer skills (including software applications such as Microsoft Office Product and Lotus Notes) needed for electronic documentation of case reviews PREFERRED REQUIREMENTS: * 3 years Managed Care experienceThis is a Telecommute (Remote) role: Must reside withing 250 miles of the office or anywhere within the posted state.#LI-MG1Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!Pay Transparency Statement:At Health Care Service Corporation, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From health and wellness benefits, 401(k) savings plan, pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for employees. Learn more about our benefit offerings by visiting <a href="https://careers.hcsc.com/totalrewards" target="_blank">https://careers.hcsc.com/totalrewards</a>.The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan.<h2>HCSC Employment Statement:</h2>We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics.<h1>Base Pay Range</h1>$187,700.00 - $348,600.00

Blue Cross and Blue Shield of Oklahoma

Medical Director

<a href="#"> </a> <a href="#">About Us</a> <a href="#">Current Employee Job Search</a> <a href="#">Go to Hillcrest HealthCare System Careers</a> <ul> <li> <a href="#">Home</a> <a href="#">Home</a> </li> <li> <a href="#">Locations</a> <a href="#">Locations</a> </li> <li> <a href="#">Nursing Careers</a> <a href="#">Nursing Careers</a> </li> <li> <a href="#">Provider Careers</a> <a href="#">Provider Careers</a> </li> <li> <a href="#">Corporate Careers</a> <a href="#">Corporate Careers</a> </li> <li> <a href="#">Executive Careers</a> <a href="#">Executive Careers</a> </li> <li> <a href="#">Join Talent Community</a> <a href="#">Join Talent Community</a> </li> </ul> <ul> <li> <a href="#">Home</a> </li> <li> <a href="#">Locations</a> </li> <li> <a href="#">Nursing Careers</a> </li> <li> <a href="#">Provider Careers</a> </li> <li> <a href="#">Corporate Careers</a> </li> <li> <a href="#">Executive Careers</a> </li> <li> <a href="#">Join Talent Community</a> </li> <li> <ul> <li><a href="#">Careers Home</a></li> <li><a href="#">Search Jobs</a></li> </ul> </li> </ul> Candidates residing in the following states, CA, CO, CT, HI, IL, MA, MD, ME, MI, MN, NH, NV, NY, OR, RI, VT, WA, Washington DC and WV, must be willing to relocate if they are hired in a remote role. We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class. FOLLOW US <a href="https://www.linkedin.com/company/hillcrest-healthcare-system" target="_blank"> </a> <a href="https://www.youtube.com/user/HillcrestMedicalCtr" target="_blank"> </a> <a href="https://www.facebook.com/UticaPark" target="_blank"> </a> <h4>ARDENT HEALTH SERVICES</h4> Ardent Health Services invests in quality health care. In people, technology, facilities and communities, Ardent makes considerable investments – producing high quality care and extraordinary results. <h4>CONTACT US</h4> 340 Seven Springs Way Suite 100, Brentwood, TN 37027 (615) 296-3000 We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class. Copyright © Ardent Health Services. All rights reserved. <a href="#">Providerrecruitment@ardenthealth.com</a> <a href="#">Providerrecruitment@ardenthealth.com</a> <a href="#">Providerrecruitment@ardenthealth.com</a> <a href="#">Providerrecruitment@ardenthealth.com</a> <a href="#">Providerrecruitment@ardenthealth.com</a> <a href="#">Providerrecruitment@ardenthealth.com</a>

Shape the Future of Cardiology: Full-Time ACNP at Oklahoma Heart Institute!

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: The Director, Risk Adjustment is a key strategic leader responsible for driving the Risk Adjustment for various lines of business and achieving related revenue targets. This includes identifying opportunities to improve completeness as well as accuracy of risk adjustment data submitted to CMS and HHS. This leader is also responsible for the development, analysis and reporting of key risk adjustment metrics, as well as overseeing analyses of new legislation and regulations regarding Risk Adjustment and assessing the impact of any changes in the programs.<ul> <li>Partner with executive leadership to plan the strategic direction of Risk Adjustment initiatives to facilitate achievement of the business goals and objectives and success criteria for the future. Evaluate and oversee the development and implementation of CMS and HHS risk adjustment program changes. Incorporate changes and requirements into strategy.</li> <li>Coordinate with appropriate functional areas including Medical Management, Quality, Pharmacy, Operations, etc. as it relates to Risk Adjustment, Clinical Risk Groups and Quality initiatives. Use analytics to define Risk Adjustment focus. Identify areas to increase quality and maximize opportunities.</li> <li>Direct the development of key analytics and data to support Risk Adjustment financial forecasts, analysis and reporting to engage key stakeholders and communicate program results to the organization. Educate internal and external stakeholders on changes in regions and the critical nature of risk adjustment and recommend areas of process improvement.</li> <li>Maximize return on investment in Risk Adjustment operations by reducing reliance on vendors and increasing validity of data submissions.</li> <li>Maintain and oversee an effective and optimal Risk Adjustment submission process and Quality Assurance Program. Monitor, measure and communicate Risk Adjustment performance and submission quality relative to the various program strategies.</li> <li>Develop performance targets for both internal and external constituents. Ensure that performance targets are set and included in contracts where appropriate. Track progress against stated goals and drive to attainment.</li> <li>Verify that data submissions are complete and accurate and that the pertinent authority has confirmed receipt. Serve as the subject matter expert in projects and initiatives. Drive Risk Adjustment best-practices across all lines of business.</li> <li>Ensure alignment and attainment of Risk Adjustment goals with business owners. Develop and implement employee training and provider outreach programs, as needed, to improve Risk Adjustment performance.</li> </ul>Education/Experience:<ul> <li>Bachelor's degree in applicable field or equivalent experience required</li> <li>Position requires at least two years of experience with Risk Adjustment.</li> <li>Experience at a Manager or Director level is preferred.</li> <li>Experience with actuarial, finance and/or operational activities of a health plan.</li> <li>Demonstrated success in improving Risk Adjustment measures.</li> <li>Demonstrated success leading cross-functional teams.</li> <li>Ability to prioritize tasks with competing deadlines.</li> </ul>Pay Range: $110,900.00 - $205,000.00 per yearCentene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law. Total compensation may also include additional forms of incentives.Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

Director, Risk Adjustment

You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. ***Remote role. Preferred candidate has strong background in Utilization Management/Claims Review and/or Appeals.***Position Purpose: Performs clinical reviews needed to resolve and process appeals by reviewing medical records and clinical data to determine medical necessity for services in accordance with policies, guidelines, and National Committee for Quality Assurance (NCQA) standards.<ul> <li>Prepares case reviews for Medical Directors by researching the appeal, reviewing applicable criteria, and analyzing the basis for the appeal</li> <li>Ensures timely review, processing, and response to appeal in accordance with State, Federal and NCQA standards</li> <li>Communicates with members, providers, facilities, and other departments regarding appeals requests</li> <li>Generates appropriate appeals resolution communication and reporting for the member and provider in accordance with company policies, State, Federal and NCQA standards</li> <li>Works with leadership to increase the consistency, efficiency, and appropriateness of responses of all appeals requests</li> <li>Partners with interdepartmental teams to improve clinical appeals processes and procedures to prevent recurrences based on industry best practices</li> <li>Performs other duties as assigned</li> <li>Complies with all policies and standards</li> </ul>Education/Experience: Requires Graduate from an Accredited School of Nursing or Bachelor’s degree in Nursing and 2 – 4 years of related experience. Knowledge of NCQA, Medicare and Medicaid regulations preferred. Knowledge of utilization management processes preferred. License/Certification:<ul> <li>LPN - Licensed Practical Nurse - State Licensure required or</li> <li>LVN - Licensed Vocational Nurse required or</li> <li>RN - Registered Nurse - State Licensure and/or Compact State Licensure required or</li> <li>LCSW- License Clinical Social Worker required or</li> <li>LMHC-Licensed Mental Health Counselor required or</li> <li>LPC-Licensed Professional Counselor required or</li> <li>Licensed Marital and Family Therapist (LMFT) required or</li> <li>Licensed Psychologist required</li> </ul>Pay Range: $26.50 - $47.59 per hourCentene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law. Total compensation may also include additional forms of incentives.Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

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