- Humana (Springfield, IL)
- …development; and + Creating and executing comprehensive test plans + Ongoing Medicaid pricer maintenance, quality assurance, and compliance + Determining root ... a part of our caring community and help us put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business Intelligence… more
- CenterWell (Springfield, IL)
- …for multiple Medicaid markets. This role is responsible to ensure compliance with client contracts, as well as to identify opportunities and implement program ... us put health first** The Lead - Medicaid Customer Success oversees strategy and operations...of home health services, and fourth largest pharmacy benefit manager , CenterWell is focused on whole-person health by addressing… more
- Humana (Springfield, IL)
- …a Care Manager /Care Coach/Care Coordinator/Service Coordinator in a Medicare or Medicaid market **OR** two (2) or more years of professional training experience ... have met all company training requirements for company, quality, and regulatory compliance . + Analyzes course evaluations to judge the effectiveness of training… more
- CVS Health (Springfield, IL)
- …accreditation from the National Health Care Anti-Fraud Association (AHFI) + Experience In Medicaid Compliance , Medicaid Investigations, MCO Medicaid FWA ... Healthcare Program Integrity, Medicaid Special Investigation or Medicaid / Medicare / Commercial Compliance role...Investigation or Medicaid / Medicare / Commercial Compliance role + Strong verbal and written communication skills.… more
- Prime Therapeutics (Springfield, IL)
- … with federal laws, state laws and standards of practice which govern the Medicaid Drug Rebate Program. + Ensures compliance with each State Medicaid ... passion and drives every decision we make. **Job Posting Title** Manager Rebate Pharmacy Operations **Job Description Summary** This position provides administrative… more
- Humana (Springfield, IL)
- …help us put health first** Humana Gold Plus Integrated is seeking a Manager of Provider Engagement who leads a team of provider relations professionals responsible ... plan of Illinois through day-to-day, front-line relationship management. The Manager is responsible for facilitating a positive provider relationship management… more
- WelbeHealth (Springfield, IL)
- …core values and our participant-focus lead the way no matter what. The Accounting Manager , Revenue and Reporting will have a unique opportunity to bridge the gap of ... Fulfillment of the role will also include driving efficiency in compliance reporting/revenue rate filings and leveraging insights to improve financial performance… more
- Little City Foundation (Grayslake, IL)
- Case Manager - Grayslake Job Details Job Location Grayslake - Grayslake, IL Position Type Full Time Education Level BA Human Svc |1yrs exp| QIDP eligible Job Shift ... To Apply for the position: Follow this link and type in Case Manager - GraysLake in the search Engine: https://littlecity.org/careers/. PURPOSE: The Case Manager … more
- CVS Health (Springfield, IL)
- …it all with heart, each and every day. The Certified Professional Coder (CPC) Manager will oversee a team of medical coders within the Special Investigations Unit ... (SIU) to ensure compliance with coding practices through comprehensive record reviews for...medical, behavioral, transportation, and other healthcare providers. The CPC Manager will be responsible for guiding the team in… more
- Humana (Springfield, IL)
- …help us put health first** Humana's Marketing organization is seeking a Lead Product Manager who specializes in Next Best Action (NBA) Decision Engine to join the ... to deliver simple, personalized, and empathetic health experiences. As the Lead Product Manager for the Next Best Action (NBA) Decision Engine on the MarTech… more