- Humana (Schaumburg, IL)
- **Become a part of our caring community and help us put health first** The Care Management Support Assistant 2 contributes to administration of care ... the care and wellbeing of members. The Care Management Support Assistant 2...+ Bilingual a plus. + Previous experience working with Medicaid , Long Term Care , or Medicare members.… more
- Humana (Springfield, IL)
- …expectations. + Conducts executive-level briefings and presents solution recommendations in support of state-level initiatives. + Supports Medicaid IT leadership ... may meet this need + 5 + years managed care experience + 5 + years in Medicaid...healthcare operations, particularly around claims processing, enrollment, provider data management and clinical operations; Medicaid preferred +… more
- Humana (Springfield, IL)
- …caring community and help us put health first** Design and maintain Medicaid claims analytics dataset using Databricks. Conduct in-depth analysis of healthcare ... and reporting. Identify cost drivers, utilization patterns, and anomalies in Medicaid medical claims data. Maintain dashboards to communicate key trends to… more
- Humana (Springfield, IL)
- …business administration, or a related field. + 3+ years of experience in Medicaid and Dual Eligible product management . + Strong understanding of health ... a part of our caring community and help us put health first** Humana Medicaid is seeking a dynamic and strategic Senior Insurance Product Manager to join our… more
- Humana (Springfield, IL)
- …development, and management of Power BI dashboards and analytics initiatives to support Medicare/ Medicaid care management programs. The role ... DAX solutions for healthcare or Medicare/ Medicaid analytics. + Knowledge of Medicare/ Medicaid care management reporting and performance metrics. +… more
- CVS Health (IL)
- …residency -Health plan/payor Utilization Management / Review experience. -Managed Care experience. - Medicaid experience. **Education:** -M.D. or DO **Pay ... opportunity with Aetna, a CVS Health company! Aetna operates Medicaid Managed Care Plans in multiple states:...Aetna Better Health Plan of Illinois. This UM (Utilization Management ) Medical Director will be a "Work from Home"… more
- Prime Therapeutics (Springfield, IL)
- …and at times, lead client-facing initiatives; provide input into, and client management support for initiatives such as implementations, setting performance ... Senior Account Manager is responsible for providing complex level support for the North Carolina Medicaid business...client, or Prime leadership + Work directly with account management to optimize the pharmacy spend through adoption and… more
- Humana (Springfield, IL)
- …cost, improving member health outcomes, or otherwise producing value within Humana's Medicaid block of business. Important skills include: - ability to critically ... defend the results of the analysis. - strong technical skills - time management and organization skills. **Use your skills to make an impact** **Required… more
- CVS Health (Chicago, IL)
- …of plan experience and identification of opportunities for improved care management , in collaboration with plan leadership. + Support for reserving and ... with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions company, we...on these issues. **A Brief Overview** + Provide actuarial support for the **Texas and Oklahoma Medicaid **… more
- Humana (Springfield, IL)
- …and help us put health first** The Senior Encounter Data Management Professional develops business processes to ensure successful submission and reconciliation ... of encounter submissions to Medicaid /Medicare. Ensures encounter submissions meet or exceed all compliance...objectives and approaches to assignments. The Senior Encounter Data Management Professional leads a team of 2-5 associates who… more