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Jobs at CommunityCare (Now Hiring) — 28 open

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Business Intelligence - Health Data Analyst

Tulsa, Oklahoma, United States · On-site

Entry level

JOB SUMMARY: The Analyst provides analytical support for all departments, including analysis, pricing, capitation, network and provider specific reporting. Analytical support includes creating and executing beginner and …

Skills: Data Analysis, Statistical Analysis, Data Modeling, SQL, SAS

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Claims HMO - Claims Examiner 140-1004

Tulsa, Oklahoma, United States · On-site

Mid level

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 appropriat…

Skills: Claims Adjudication, Medical Terminology, CPT Codes, Claims Processing, Microsoft Office

CommunityCare logoCommunityCare

Medical Management - Utilization Management RN 145-2037

Tulsa, Oklahoma, United States · On-site

Mid level

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 memb…

Skills: Utilization Review, Clinical Review, Medical Necessity Assessment, Care Coordination, Case Management

CommunityCare logoCommunityCare

Medicare & Individual Marketing - Individual Health Plans Market Development Consultant 176-1030

Tulsa, Oklahoma, United States · On-site

Mid level

JOB SUMMARY: This position works under the Marketing Department and serves as the primary strategic resource for the Individual & Family Plan line of business. This role is responsible for coordinating growth strategies,…

Skills: Strategic Planning, Market Development, Broker Relations, Training and Education, Data Analysis

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Grievance & Appeals - Grievance & Appeals Coordinator 201-1000

Tulsa, Oklahoma, United States · On-site

Senior

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 …

Skills: Grievance and Appeals Processing, Regulatory Compliance, Customer Service, Case Documentation, Microsoft Office

CommunityCare logoCommunityCare

Business Intelligence - Health Data Analyst-133-2008

Tulsa, Oklahoma, United States · On-site

Entry level

JOB SUMMARY: The Analyst provides analytical support for all departments, including analysis, pricing, capitation, network and provider specific reporting. Analytical support includes creating and executing beginner and …

Skills: Data Analysis, Statistical Analysis, Data Modeling, SQL, SAS

CommunityCare logoCommunityCare

Accounting - Accounts Payable Clerk 125-1012

Tulsa, Oklahoma, United States · On-site

Mid level

JOB SUMMARY: Responsible for performing a range of account entry and reconciliation activities to provide support to the company’s accounting and financial reporting functions. KEY RESPONSIBILITIES: Verifies the ac…

Skills: Account Entry, Reconciliation, Invoice Coding, ACH Payments, Expense Report Review

CommunityCare logoCommunityCare

Clinical Pharmacy - Managed Care Clinical Pharmacist 146-2005

Tulsa, Oklahoma, United States · On-site

Senior

JOB SUMMARY: The Managed Care Clinical Pharmacist will provide clinical pharmacy support to the CommunityCare Pharmacy Department including development of criteria for medications requiring a prior authorization, managem…

Skills: Managed Care, Clinical Pharmacy, Prior Authorization, Drug Utilization Review, Medication Therapy Management

CommunityCare logoCommunityCare

Quality Improvement - Manager STARS

Tulsa, Oklahoma, United States · On-site

Senior

Job Summary: The Stars Manager is responsible for leading the design, implementation, and continuous improvement of strategies to achieve and maintain superior CMS Star Ratings. This role serves as the key driver of cros…

Skills: CMS Star Ratings, Data Analytics, Project Management, HEDIS Engagement, Regulatory Compliance

CommunityCare logoCommunityCare

Software Engineering - Senior Software Engineer

Tulsa, Oklahoma, United States · Hybrid

Senior

JOB SUMMARY: CommunityCare HMO, Inc. seeks a Senior Software Engineer to perform advanced backend software development, ensuring high performance and reliability. Write efficient, maintainable code for APIs and other mid…

Skills: C#, .NET, Microsoft SQL, API Development, Object-Oriented Design

CommunityCare logoCommunityCare

Information Technology - Machine Learning Engineer

Tulsa, Oklahoma, United States · Hybrid

Entry level

JOB SUMMARY: CommunityCare HMO, Inc. seeks a Machine Learning Engineer to develop machine learning models for healthcare and payer applications, including but not limited to natural language processing, medical claims, r…

Skills: Machine Learning, Natural Language Processing, Predictive Analytics, Deep Learning, ETL Workflows

CommunityCare logoCommunityCare

Customer Service - Customer Service Representative Commercial 105-1065

Tulsa, Oklahoma, United States · On-site

Entry level

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…

Skills: Customer Service, Active Listening, Conflict Resolution, Time Management, Decision Making

CommunityCare logoCommunityCare

Medical Management - Utilization Management RN 145-2011

Tulsa, Oklahoma, United States · On-site

Mid level

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 memb…

Skills: Utilization Review, Clinical Review, Medical Necessity Assessment, Care Coordination, Case Management

CommunityCare logoCommunityCare

Accounting - Accounts Receivable Specialist 125-1009

Tulsa, Oklahoma, United States · On-site

Mid level

JOB SUMMARY: Support revenue cycle through accurate billing, payment processing, and customer account maintenance. Plans include Medicare, Marketplace, Group coverage and EAP. Collaborates closely with internal teams and…

Skills: Accounts Receivable, Billing, Payment Processing, Customer Account Maintenance, Accounting Principles

CommunityCare logoCommunityCare

Medical Management - Medical Review Examiner Nurse 135-1009

Tulsa, Oklahoma, United States · On-site

Senior

JOB SUMMARY: 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 …

Skills: Claims Auditing, Medical Coding, Clinical Appropriateness Review, Fraud Waste and Abuse Identification, Data Analysis

CommunityCare logoCommunityCare

Claims HMO - Claims Examiner 140-1044

Tulsa, Oklahoma, United States · On-site

Mid level

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 appropriat…

Skills: Claims Adjudication, Medical Terminology, CPT Codes, Claims Processing, Microsoft Office

CommunityCare logoCommunityCare

Claims HMO - Complex Claims Specialist 140-1039

Tulsa, Oklahoma, United States · On-site

Mid level

JOB SUMMARY: The Complex Claims Specialist is responsible for examining claims that require review prior to being adjudicated. Claims are generally of the largest dollar value and require extreme attention to detail and …

Skills: Claims Adjudication, Medical Billing, CPT Codes, Medical Terminology, Contract Analysis

CommunityCare logoCommunityCare

Claims HMO - Complex Claims Specialist 140-1021

Tulsa, Oklahoma, United States · On-site

Mid level

JOB SUMMARY: The Complex Claims Specialist is responsible for examining claims that require review prior to being adjudicated. Claims are generally of the largest dollar value and require extreme attention to detail and …

Skills: Claims Adjudication, Medical Terminology, CPT Codes, Contract Analysis, Data Entry

CommunityCare logoCommunityCare

Claims HMO - Claims Examiner 140-1040

Tulsa, Oklahoma, United States · On-site

Mid level

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 appropriat…

Skills: Claims Adjudication, Medical Terminology, CPT Codes, Claims Processing, Medical Billing

CommunityCare logoCommunityCare

Claims HMO - Claims Examiner 140-1028

Tulsa, Oklahoma, United States · On-site

Mid level

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 appropriat…

Skills: Claims Adjudication, Medical Terminology, CPT Codes, Claims Processing, Medical Billing

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Showing 1–20 of 28

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Business Intelligence - Health Data Analyst

CommunityCare

Tulsa, Oklahoma, United States • On-site

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Entry level

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  • Full-time
  • bachelor degree
  • Posted 1d ago
  • ~40 hrs/week

Responsibilities

The Analyst provides analytical support across departments by creating and executing reports, performing data modeling, and conducting statistical analysis. They collaborate with stakeholders to deliver ad-hoc analyses and maintain the Departmental Data Warehouse.

Requirements

A Bachelor's degree in a quantitative field is required, with 1-2 years of related experience preferred. Proficiency in analytical software such as SQL, SAS, Power BI, or Tableau is highly desired.

Full job description

JOB SUMMARY:

The Analyst provides analytical support for all departments, including analysis, pricing, capitation, network and provider specific reporting. Analytical support includes creating and executing beginner and intermediate level reports and programs and programming modifications to previously written reports. The Analyst will collaborate with key stakeholders and determine the needed result including any special specifications. The Analyst will work with several databases to pull and integrate data, statistical analysis and data modeling.

 

KEY RESPONSIBILITIES:

  • Execute, write, test, validate, analyze and distribute reports. Determine appropriate approach and tools needed to complete project in an efficient and timely manner.  Collaborate with key stakeholders and senior analysts. 
  • Determine, write and present report results with key findings and trends to appropriate stakeholders.
  • Complete multiple concurrent ad-hoc analyses, provide corresponding reports based on customer specifications, determine and communicate analytical conclusions and recommendations. 
  • Develop beginner to intermediate level reports and ad-hoc analysis based on specifications outlined by department management.  Automate such reports and ensure that they are performed and delivered on schedule. 
  • Perform tasks related to maintenance of Departmental Data Warehouse and its documentation.
  • Perform other job-related duties as assigned.

 

QUALIFICATIONS:

  • Ability to apply advanced mathematical and statistical techniques and principles into the analysis of health-related data.
  • Possess strong oral and written communication skills with the ability to communicate results in a clear and concise manner.
  • Ability to converse and write fluently in English.
  • Successful completion of Health Care Sanctions background check.
  • Proficient in Microsoft Office applications.

 

EDUCATION/EXPERIENCE:

  • Bachelor’s degree Required.  Mathematics, Statistics, Economics, Actuarial Science or other quantitative discipline preferred.
  • Demonstrated use of analytical software. SAS or SQL preferred.
  • Experience in Power BI, Tableau or similar software preferred.1-2 years of related experience preferred.

CommunityCare is an equal opportunity at will employer and does not discriminate against any employee or applicant for employment because of age, race, religion, color, disability, sex, sexual orientation or national origin

 

Related keywords

Business IntelligenceHealth DataCapitationNetwork ReportingProvider ReportingData WarehouseMathematicsStatisticsEconomicsActuarial ScienceSQLSASPower BITableauAd-hoc AnalysisData Integration

About CommunityCare

LinkedInVisit site

Caring for Oklahomans like no other health plan can or does.

Industry
Insurance
Company size
201-500 employees
Founded
1993
Headquarters
Tulsa, OK
LinkedIn followers
10,496

CommunityCare is Oklahoma's largest locally owned health plan. Products offered include group and individual plans, Medicare Advantage plans, an employee assistance program and a workers' compensation plan. Located in Tulsa, CommunityCare is owned by Ascension St. John and Saint Francis Health System. CommunityCare is proud to be Oklahoma’s best choice for health care.

Offices: Two West Second Street, Suite 100, Tulsa, OK 74103, US

Health CareHealth Insurance
View all jobs at CommunityCare

About CommunityCare

LinkedInVisit site

Caring for Oklahomans like no other health plan can or does.

Industry
Insurance
Company size
201-500 employees
Founded
1993
Headquarters
Tulsa, OK
LinkedIn followers
10,496

CommunityCare is Oklahoma's largest locally owned health plan. Products offered include group and individual plans, Medicare Advantage plans, an employee assistance program and a workers' compensation plan. Located in Tulsa, CommunityCare is owned by Ascension St. John and Saint Francis Health System. CommunityCare is proud to be Oklahoma’s best choice for health care.

Offices: Two West Second Street, Suite 100, Tulsa, OK 74103, US

Health CareHealth Insurance
View all jobs at CommunityCare

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