- DATAMAXIS (Springfield, IL)
- …distance (3 - 5 Hours) of Springfield, IL. Functional Description: This position is a Medicaid Subject Matter Expert for the Illinois Enterprise Data ... Provide direction, guidance and recommendations supporting decision making for large Medicaid data warehouse implementation and operations. * With the specialized… more
- Mathematica (Chicago, IL)
- …to build additional capabilities. + Represents Mathematica to clients as project director or subject matter expert ; able to engage clients to work through ... could be focused on improving the Medicare, Medicare Advantage, Medicaid , and veterans and military focused programs, as well...of demonstrated effectiveness functioning as a senior researcher or subject matter expert on substantial… more
- Molina Healthcare (Bloomington, IL)
- …to refer clients who may be eligible for other Molina products. + Viewed as a " subject matter expert " (SME) by community and influencers on the health care ... promotion and advocacy. + Strong presentation skills and broad knowledge of Illinois Medicaid is helpful. **If you are passionate about community engagement and have… more
- Public Consulting Group (Springfield, IL)
- …of Medicaid waivers. **Duties and Responsibilities** + Serves as project manager and subject matter expert within the practice including management of a ... . Summary: We are seeking a senior-level, detail-oriented and self-motivated Medicaid Waiver Evaluation Consultant to join our team. This role involves… more
- Prime Therapeutics (Springfield, IL)
- …maintenance of regulatory requirements throughout the enterprise. This position acts as the subject matter expert on applicable regulations, training, and ... customer needs with business goals. + Consults with business areas and other subject matter experts to identify compliance requirements, assess risks, and… more
- Public Consulting Group (Springfield, IL)
- …for OCM Plan, and execution of the plan as lead advisor * Operate independently as a lead and Subject Matter Expert * Lead a team of OCM, and non SME team to ... + Business Solutions + Project Assurance An OCM consultant will provide expert support and guidance to clients ensuring projects meet objectives by increasing… more
- CVS Health (Chicago, IL)
- …and every day. **Position Summary** The individual in this role will serve as the subject matter expert for Aetna's Medicare Advantage Special Needs Plans ... all Aetna geographies, Medicare Advantage market actuaries, and associated Medicaid actuaries. Establish best practices, ensure consistency, and provide guidance… more
- Humana (Springfield, IL)
- …attending required conferences and also create content to lead/teach/present for individual subject matter contribution + Passionate about contributing to an ... submitted medical records, synthesizing complex hospital-based clinical scenarios, and providing expert decisioning on the requested services. They will have regular… more
- J&J Family of Companies (IL)
- …identify and resolve trending issues regarding patient access to therapies. + Serve as subject matter expert for internal stakeholders and external office ... staff regarding the Medicare treatment guidelines, Medicaid Managed Care, commercial plans, policy changes, formulary status and the impact of healthcare reform on… more
- CVS Health (Springfield, IL)
- …record auditing skills and abstraction expertise. + Serves as the training resource and subject matter expert to vendors, providers and other team members ... the ICD-10 codes that are submitted to the Centers for Medicare and Medicaid Services (CMS) for the purpose of risk adjustment processes are appropriate, accurate,… more