Location
Remote, OK, United States
Posted
July 11, 2026
Job Description
**It's more than a career, it's a calling.**
OK-REMOTE
**Worker Type:**
Regular
**Job Summary:**
Evaluates the medical necessity and appropriateness of hospital admissions and surgical procedures. Ensures payors receive clinical information to support services provided by hospital. Ensures hospital receives authorization from payor.
**Job Responsibilities and Requirements:**
PRIMARY RESPONSIBILITIES
+ Discusses with payor regarding criteria and payor decision.
+ Escalates denials to physician (advisor, attending consultant, outside consultant) for peer to peer consideration.
+ Documents outcome in electronic medical record.
+ Participates with other members of team regarding opportunities for improvement in standard work.
+ Performs review of pre-admission, perioperative, and post operative surgical cases.
+ Performs other utilization management tasks as assigned.
+ Applies the existing body of ev...
OK-REMOTE
**Worker Type:**
Regular
**Job Summary:**
Evaluates the medical necessity and appropriateness of hospital admissions and surgical procedures. Ensures payors receive clinical information to support services provided by hospital. Ensures hospital receives authorization from payor.
**Job Responsibilities and Requirements:**
PRIMARY RESPONSIBILITIES
+ Discusses with payor regarding criteria and payor decision.
+ Escalates denials to physician (advisor, attending consultant, outside consultant) for peer to peer consideration.
+ Documents outcome in electronic medical record.
+ Participates with other members of team regarding opportunities for improvement in standard work.
+ Performs review of pre-admission, perioperative, and post operative surgical cases.
+ Performs other utilization management tasks as assigned.
+ Applies the existing body of ev...