• Medical Director - Medicaid Team…

    Humana (Springfield, IL)
    …Information** Typically reports to a Regional Vice President of Health Services, Lead, or Corporate Medical Director , depending on size of region or line ... caring community and help us put health first** The Medical Director relies on medical ...materials, internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and … more
    Humana (10/28/25)
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  • Medical Director - Mid West Region

    Humana (Springfield, IL)
    …the Medicare Line of Business. **Additional Information** Typically reports to Lead or Corporate Medical Director , depending on size of region or line of ... caring community and help us put health first** The Medical Director actively uses their medical...reference materials, internal teaching conferences, and other reference sources. Medical Directors will learn Medicare and … more
    Humana (09/16/25)
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  • Director , Quality and Risk Adjustment

    Humana (Springfield, IL)
    …a part of our caring community and help us put health first** The Director , Quality and Risk Adjustment has regional oversight of the development and implementation ... of the company Medicare /Medicaid Stars Program. Oversees Stars quality improvement programs and...is submitted to CMS and other governmental agencies. The Director , Quality and Risk Adjustment requires an in-depth understanding… more
    Humana (10/30/25)
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  • Chief Psychiatrist - Behavioral Health…

    Humana (Springfield, IL)
    …and build collaborative care models in their practices + Coordinates with the Medical Director to integrate the administration and management of behavioral and ... in this role collaborates closely with Clinical Services and the Chief Medical Officer(CMO) to integrate the day-to-day administration and strategic management of… more
    Humana (10/23/25)
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  • Manager, Special Investigation

    CVS Health (Springfield, IL)
    …every day. **Position Summary** Job Description **A Brief Overview** Oversees corporate activities related to the prevention, investigation, and prosecution of ... for compliance with state and federal regulations mandating the reporting of corporate fraud-related activities and the preparation of the Corporate Anti-Fraud… more
    CVS Health (10/19/25)
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  • Reviewer-Orthopedic Disease Specific Care

    The Joint Commission (Oakbrook Terrace, IL)
    …appropriate judgment to seek assistance from others, including Central Office, the Field Director on call, the program specific Field Director , the Standards ... periodic performance reviews, evidence of standards compliance reports, complaints, and Medicare out-of-compliance reports. + Collaborate in a productive manner with… more
    The Joint Commission (10/25/25)
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