- Polaris Pharmacy Services, LLC (Des Plaines, IL)
- …is responsible for managing and identifying a portfolio of rejected pharmacy claims to ensure maximum payer reimbursement and timely billing to eliminate financial ... + Manage and identify a portfolio of rejected pharmacy claims to ensure maximum payer reimbursement and timely billing...of the business. BENEFITS for full time Employees + Medical , Dental, and Vision insurance + 401 (k) (available… more
- Evolent (Springfield, IL)
- …team at Evolent. This individual will be primarily focused on distilling medical economics insights from product strategy analyses and translating them to complex ... fostering trust, expertise and cooperation. + Extract, manage, and analyze claims and operational data using industry-standard metrics. + Process and validate… more
- Sedgwick (Naperville, IL)
- …combination of education and experience required to include two (2) years of claims management, managed care or other related experience. **Skills & Knowledge** + In ... depth knowledge of claims management, managed care and/or absence management processes and...benefits package is offered including but not limited to, medical , dental, vision, 401k and matching, PTO, disability and… more
- Xeris Pharmaceuticals, Inc. (Chicago, IL)
- …activity + Partner with cross-functional teams (eg, Marketing, Market Access, Sales, Medical Affairs, Finance) to align on business questions and translate them into ... of primary/secondary insights + Leverage syndicated data (eg, IQVIA, claims data) and internal data assets to develop a...business rules used to issue product alerts based on claims data + Respond to and develop solutions for… more
- AbbVie (Mettawa, IL)
- …+ Professional training in a healthcare field, experience in analysis of large medical claims datasets or prior experience in the UNIX/Hadoop environment ... methods, and technical programming skills to analyze clinical, survey, claims , and electronic medical record databases. Role...to analyze clinical, survey, claims , and electronic medical record databases. Role supports the department as a… more
- CenterWell (Springfield, IL)
- …+ Know and continually review medication brand and generic names, medical terminology, and pharmaceutical calculations. + Medication adherence outreach, auditing, ... + Assist clinical pharmacists in troubleshooting prescription third party claim rejections by accessing and understanding formulary restrictions, plan limitations,… more
- Otsuka America Pharmaceutical Inc. (Springfield, IL)
- …customer engagement platforms, starting with, but not limited to, Otsuka's Medical Affairs Disease State Engagement platforms (PsychU, PsychUsim, ADPKDsim, and ... align our platform initiatives to corporate, above brand and medical strategies. This successful candidate will need strong project...you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more
- Sharecare (Springfield, IL)
- …eligibility, benefit education, open enrollment / new hire plan selection, claims issues, ID card issues, grievances/appeals, utilization management (UM) status, ... including but not limited to medical , dental, and vision plans + Provider search (PCP,...resolution with providers, payers or 3rd parties for: + Claims adjustments + Grievances and appeals submissions + Utilization… more
- Sumitomo Pharma (Springfield, IL)
- …company's new and established programs. This position reports to the Chief Medical Officer. **Job Duties and Responsibilities** + Strategic thought partner including ... and operational leadership to the Marketing Brand Teams, Legal, Medical Affairs and Clinical Research in the development of...the adequacy of clinical evidence provided to support proposed claims and assess consistency of proposed claims … more
- Otsuka America Pharmaceutical Inc. (Springfield, IL)
- …innovative products, with a focus on pharmaceutical products to meet unmet medical needs and nutraceutical products for the maintenance of everyday health. In ... a superior experience. The "ecosystem approach" unifies account management, medical , patient access, and market access teams to engage...you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more