• Medicaid Subject Matter

    DATAMAXIS (Springfield, IL)
    …Provide direction, guidance and recommendations supporting decision making for large Medicaid data warehouse implementation and operations. + With the specialized ... knowledge of the Medicaid and Children's Health Insurance Programs, lead and guide...and third-party liability. + Proactively identify and understand state Medicaid agency data needs and determines the recommended solution… more
    DATAMAXIS (03/29/25)
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  • Project Manager- Medicaid Contracts…

    CVS Health (Springfield, IL)
    …system implementation, and performing post-release checkout + Act as Project Manager/ subject matter expert on Conga Medicaid Contracting for all ... Platform Solutions - Contracts & Pricing Team to support Medicaid Contracting IT projects in Conga and to provide...+ Maintain reports and dashboards for executive leadership and Medicaid Health Plans + Support of internal and external… more
    CVS Health (04/24/25)
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  • Director Proposal Strategy - Medicaid

    Elevance Health (Chicago, IL)
    …interacting confidently with senior management and executive level stakeholders, as a subject matter expert and comfortable with influencing decision-making ... **Director Proposal Strategy - Medicaid ** **Location:** Alternate locations may be considered. This...equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this… more
    Elevance Health (04/23/25)
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  • Senior Functional Business Consultant- REMOTE

    Prime Therapeutics (Springfield, IL)
    …Description** The Functional Business Consultant serves as a business system or business process subject matter expert with a high level of understanding of ... Represents assigned business system or business process as a subject matter expert in business...process change and/or project management in supporting Compliance with Medicaid requirements. + Provide direct, or indirect leadership to… more
    Prime Therapeutics (04/25/25)
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  • Value-Based Reimbursement Specialist

    Highmark Health (Springfield, IL)
    …team education support. Will participate on a portfolio of projects. + Serve as a subject matter expert working in concert with provider-facing teams to ... goals including but not limited to Government Markets (STARS, ACA, CHIP, Medicaid DE) and Enterprise Quality, Safety, and Values (Health Outcomes Measures). Provide… more
    Highmark Health (04/17/25)
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  • Field Reimbursement Manager (Oncology) - (Central…

    J&J Family of Companies (Chicago, IL)
    …departments such as marketing, sales, medical science, SCG, IBG, HCC, and PECS. Serve as subject matter expert regarding education and insights on access and ... representatives and key account managers and serve as reimbursement expert for the local team . Act with a...solutions across multiple payer types and plans (ie, Medicare, Medicaid Managed Care, Commercial). . Execute business in accordance… more
    J&J Family of Companies (04/30/25)
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  • Vice President, Compliance Business Partner…

    Option Care Health (Chicago, IL)
    …decision-making within ethical boundaries and optimizing business performance. Serves as a subject matter expert in health care compliance including, ... regulatory requirements, and our compliance program. The Vice President provides expert guidance on strategic initiatives, day-to-day operations, and leads the… more
    Option Care Health (04/30/25)
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  • Field Medical Director, Interventional Cardiology…

    Evolent (Springfield, IL)
    …do not initially meet medical necessity guidelines or require further evaluation by a subject matter expert . + Conduct peer-to-peer discussions with treating ... both part-time and full-time options available.** **What You'll Do:** + Provide expert reviews for cardiovascular cases, serving as a specialty-matched expert more
    Evolent (04/30/25)
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  • Manager, Compliance - Remote

    Prime Therapeutics (Springfield, IL)
    …to management on major matters pertaining to policies, plans and objectives and provides Subject Matter Expertise in their areas of focus (Affordable Care Act, ... Medicare, Medicaid , Corporate Compliance, Compliance Assessment or Services etc.) +...enterprise training programs through a variety of channels + Expert level understanding of effective compliance program principles, concepts,… more
    Prime Therapeutics (04/19/25)
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  • Provider Relations Manager

    Molina Healthcare (Joliet, IL)
    …CSST resolution support, and National Contract Management support services. * Serves as a subject matter expert for other departments. * Conducts regular ... position requiring an in-depth knowledge of provider relations and contracting subject matter expertise to successfully engage complex providers, including… more
    Molina Healthcare (05/02/25)
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