- Humana (Springfield, IL)
- …public relations strategies. + Develops corporate communications to be shared with senior leadership. + Supports trend management by conducting analysis of drug ... Pharmacy Solutions ensuring compliance with programmatic requirements, such as claims processing, prior authorization, formulary management and clinical programming… more
- Highmark Health (Springfield, IL)
- …for non-payment, Completing write-offs as appropriate, Coordinating AR issues affecting claims or inquiry processing with Membership and Billing personnel.Lead or ... processes, Coordination of annual audits (such as PWC Revenue Audit and Support Senior Vice President of Operations in Monthly/Annual budget and expense analysis for… more
- Sanofi Group (Chicago, IL)
- …knowledge of the US healthcare system, including formulary operations, claims adjudication, specialty pharmacy networks, and contract performance tracking. We ... performance and recommend operational optimizations. + Provide timely updates to senior leadership and account management teams, highlighting trends, gaps, and… more
- CVS Health (Springfield, IL)
- …times, and client satisfaction. Provide regular reports and insights to senior management to inform strategic decision-making and drive continuous improvement in ... levers, underwriting and financial models. + Understanding of healthcare and pharmacy claims data and common tools used to manipulate data. + Exceptional… more
- Bowman (Springfield, IL)
- …complex assignments, tasks, and execution. Work is frequently reviewed by more senior staff to ensure application of sound techniques and principles. Review work ... and resolve any issues that may arise as it relates to disputes, or claims + Act as liaison between operations and many corporate accounting functions including but… more
- Medtronic (IL)
- …Clinical Expert + Translates complex technical messaging, dispels competitive claims , resolves complex technical issues, and maintains customer relationships through ... + Practical and demonstrated knowledge of project/program management practices desired for Senior and Principal Levels with the ability to complete work group… more
- Astellas Pharma (Northbrook, IL)
- …needs of target customer profiles leveraging insights and key messaging and claims as outlined in the Omnichannel Engagement Framework (OEF), or similar framework, ... Communication and presentation skills including the ability to influence and manage senior leaders and other key stakeholders **Skills, knowledge:** + Ability to… more
- Abbott (Lake Forest, IL)
- …including, for example, laws related to fraud and abuse (Anti-Kickback Statute, False Claims Act), FDA regulation (Food, Drug & Cosmetic Act), privacy (HIPAA), and ... complex matters with minimal supervision and understand which issues to elevate to senior management and appropriate timing for doing so. * In addition to top-notch… more
- The Hartford (Chicago, IL)
- …business unit. + Serve as a member of Middle and Large Commercial extended senior leadership team and provide thought leadership inside and outside the data science ... quantitative, and statistical skills in the development of pricing, financial and claims models to drive profitable growth, fight fraud, and make sound business… more
- AbbVie (Mettawa, IL)
- …prescribing, institutional sales data, payer-prescriber-level data, formulary data, Symphony/IQVIA claims , etc. + Candidate must have strong leadership skills, a ... proven ability to work closely and effectively with all corporate functions and senior management, and the ability to clearly articulate how to address patient… more