- Humana (Springfield, IL)
- …Pharmacy Solutions ensuring compliance with programmatic requirements, such as claims processing, prior authorization, formulary management and clinical programming ... with staff in different positions and all levels of management position ** Preferred Qualification** + Master's degree in public health, Business, or related field… more
- Humana (Springfield, IL)
- …The Corporate Medical Director (CMD) relies on medical background to review health claims and preservice appeals. The Corporate Medical Director works on problems of ... to an organization focused on continuously improving consumer experiences ** Preferred Qualifications** + Medical utilization management experience + Working with… more
- Legrand NA (Chicago, IL)
- …within the department policies and procedures. * Ensure promptly resolution of any claims by adhering, as much as possible, to the department policies and procedures ... to multi-task * Professional appearance and attitude Qualifications * Associate degree in business is a plus * 3-5...with the use of computer-based tools - JD Edwards ( preferred ), MS Office Suite * Salary Range: $70,000 to… more
- Humana (Springfield, IL)
- …first** The Medical Director relies on medical background and reviews health claims . The Medical Director work assignments involve moderately complex to complex ... and/or home health or post acute services such as inpatient rehabilitation. ** Preferred Qualifications** + Knowledge of the managed care industry including Medicare… more