- AbbVie (North Chicago, IL)
- …medicines and solutions that solve serious health issues today and address the medical challenges of tomorrow. We strive to have a remarkable impact on people's ... brands and frequently interact with and provide substantive advice to Marketing, Medical Affairs and Regulatory Affairs departments concerning a broad range of… more
- Humana (Springfield, IL)
- …first** The Clinical Pharmacist Lead monitors drug development pipeline, and medical literature, while providing clinical support for internal stakeholders. Utilizes ... pharmacy operations directly with the plan Chief Executive Officer and Chief Medical Officer. POSITION RESPONSIBILITIES: + Keeps current with State and Federal… more
- Robert Half Legal (Chicago, IL)
- …to support claims . * Request and manage itemized bills and medical records from healthcare providers. * Maintain accurate records and ensure compliance with ... * Communicate effectively with clients, insurance adjusters, opposing counsel, and medical providers to facilitate case progress. * Coordinate with insurance… more
- CVS Health (Springfield, IL)
- …Manager BH coordinates all case management activities with members to evaluate medical needs and to facilitate the overall wellness of members. Develops strategy ... care planning and resolution of member issues. + Handles reviews of prior claims to address potential impact on current case management and eligibility. + Creates… more
- CVS Health (Springfield, IL)
- …levers, underwriting and financial models. + Understanding of healthcare and pharmacy claims data and common tools used to manipulate data. + Exceptional ... varying levels of client contacts, including executive leadership, Chief Medical Officers, pharmacy department leadership, provider networks, actuaries, financial… more
- The Cigna Group (Springfield, IL)
- …+ Receive requests by email or telephone regarding insurance claims /policies while operating on multiple computer applications. Respond to inquiries ... level capacity to multitask independently and on a computer. + Knowledge of Medical Terminology a PLUS. + Excellent written and oral communication skills. + Ability… more
- Actalent (Schaumburg, IL)
- …deny authorizations, and make clinical determinations based on insurance and medical documents. Responsibilities + Handle intake of prior authorization requests, ... criteria. + Read and interpret criteria, SOPs, insurance documents, and medical records. + Provide excellent customer service and manage communications effectively.… more
- AbbVie (Mettawa, IL)
- …medicines and solutions that solve serious health issues today and address the medical challenges of tomorrow. We strive to have a remarkable impact on people's ... to achieve optimal commercial potential for those assets. + Partner with Medical Affairs and Clinical Development to develop scientific platform and drive data… more
- Norstella (Springfield, IL)
- …generate insights into improving population health, quality of care, efficiency of medical research, and managing costs by transforming the way analysts from diverse ... solving and structured communication skills + Understanding of healthcare databases (eg, claims , EHR, hospital, registry) and the pros/cons of various sources +… more
- NASCO (Springfield, IL)
- …with US Healthcare payer analytics use cases (eg, risk stratification, claims analytics, provider network optimization) + Certifications in cloud technologies (AWS ... Health Benefits** + Choice of Blue Cross Blue Shield Medical , Dental, and Vision Plans + Telehealthcare - for..., Dental, and Vision Plans + Telehealthcare - for Medical and Behavioral visits + Generous PTO with buy/sell… more