- Humana (Springfield, IL)
- …customers verbally and actively listening to their needs. **Preferred Qualifications** + Associate or Bachelor's degree + Previous inbound call center or related ... customer service experience + Previous healthcare experience + Bilingual in Spanish and English (see...PHI / HIPAA information. **Language Proficiency Testing** Any Humana associate who speaks with a member in a language… more
- R1 RCM (Chicago, IL)
- …automation, and workflow orchestration. Our **Multispecialty QA Education Coding Associate ** will be responsible for reviewing clinical documentation and diagnostic ... and correct billing edits, internal and external reporting, research, and regulatory compliance ). Under the direction of the Coding Leadership Team, the successful… more
- Humana (Springfield, IL)
- …dedicated team where your expertise helps break down barriers to effective healthcare , empowers individuals to achieve their best outcomes, and strengthens our ... compassionate, patient-centered service. Take the next step in your healthcare career and help shape positive change in the...to accommodate client needs. **Language Proficiency Testing** Any Humana associate who speaks with a member in a language… more
- Datavant (Springfield, IL)
- …company and the world's leader in health data exchange. Our vision is that every healthcare decision is powered by the right data, at the right time, in the right ... team. Together, we're rising to the challenge of tackling some of healthcare 's most complex problems with technology-forward solutions. Datavanters bring a diversity… more
- Humana (Springfield, IL)
- …initiatives. This role partners closely across clinical, product, operations, technology, compliance , portfolio and strategy teams to ensure the clinical operations ... manage decision criteria to evaluate requests based on business value, compliance impact, technical feasibility, and alignment with organizational goals. +… more
- Humana (Springfield, IL)
- …analysis and evaluation of variable factors to support high-quality, evidence-based healthcare delivery, regulatory compliance , and clinical innovation. **Key ... clinical and business objectives of the OCMO, prioritizing quality improvement, regulatory compliance , and innovation. + Oversee a diverse portfolio of IT projects,… more
- AdventHealth (Hinsdale, IL)
- …to maintain and improve patient outcomes. Additionally, this role ensures compliance with regulatory standards, established policies, protocols, and procedures. In ... addition, this position collaborates with other healthcare professionals to deliver comprehensive care and utilizes pertinent references as guidelines for clinical… more
- AdventHealth (Glendale Heights, IL)
- …to maintain and improve patient outcomes. Additionally, this role ensures compliance with regulatory standards, established policies, protocols, and procedures. In ... addition, this position collaborates with other healthcare professionals to deliver comprehensive care and utilizes pertinent references as guidelines for clinical… more
- Humana (Springfield, IL)
- …the QSI Data Quality/Integrity Lead will leverage their expertise in clinical/ healthcare data, data exploration, collaboration, and leadership to guide the daily ... and functionality. + Partner with internal HEDIS operations and compliance teams on the maintenance of policies, processes, and...and tools. + Minimum 6 years experience working with healthcare data and/or lab data experience + Minimum 5… more
- Humana (Springfield, IL)
- …decisioning + Strong collaboration skills with data science, engineering, compliance , and business stakeholders + Familiarity with Adobe Experience Platform ... (AEP), IVR systems, and healthcare data sources (eg, EHRs, care management platforms) +...(collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and… more