- Highmark Health (Springfield, IL)
- …Highmark Health clinical areas to support clinical quality auditing, The Senior Risk Compliance Analyst is responsible for monitoring and analyzing medical and ... utilization management activities to ensure compliance with internal policies, state, CMS, and federal regulations. This role serves as a clinical subject matter… more
- Rush University Medical Center (Chicago, IL)
- …disability, veteran status, and other legally protected characteristics. **Position** Sr Compliance Coding Analyst **Location** US:IL:Chicago **Req ID** 19006 ... to improve coding quality. Prepares various reports for administration and the Compliance Council. Represents Health Information Management and RUMC at forums that… more
- R1 RCM (Chicago, IL)
- …analytics, AI, intelligent automation, and workflow orchestration. As our R37 GenAI Lab Process Analyst in the Perfect Claim pillar, you will play a key role in both ... enabled product platform. **Here's what you will experience working as a Process Analyst :** + Analyze and optimize current edits in claim scrubbers to improve claim… more
- Convey Health Solutions (Chicago, IL)
- Job Description SUMMARY The Sr. Data Analyst will be responsible for utilizing technical and industry knowledge to accelerate analytic insights and new feature ... desired deliverables will be vital to success. Collaborating within a team, the analyst will engage with engineers, QA, Data Scientists, and Product teams using… more
- Evolent (Springfield, IL)
- …the mission. Stay for the culture. **What You'll Be Doing:** **Senior Scope Analyst , Scope Management** The Specialty Scope Management team is made up of analysts, ... opportunity to make healthcare better. **Collaboration Opportunities:** The Senior Scope Analyst , Scope Management plays a crucial role in supporting the… more
- Intermountain Health (Springfield, IL)
- **Job Description:** The RCO Rev Integrity Chargemaster Analyst II independently handles EPIC build, maintenance, and implementation of charge codes, fee schedules, ... related functions. This position is adept with Federal, State, CMS-OPPS, and regulatory/ payer requirements and will update the chargemaster as needed. This position… more
- R1 RCM (Chicago, IL)
- …and correct billing edits, internal and external reporting, research, and regulatory compliance ). Under the direction of the Coding Leadership Team, the successful ... (ie:Documentation Guidelines '95 & '97) + Extensive knowledge of government, and commercial payer guidelines. + Must be able to use standard office equipment and… more
- Highmark Health (Springfield, IL)
- …data + 3 years of project leadership in a complex, matrixed environment ( payer and/or provider preferred) + 3 years of providing analytical consultation to clinical, ... administrative, operational and financial stakeholders **Preferred** + None **LICENSES or CERTIFICATIONS** **Required** + None **Preferred** + None **SKILLS** + Demonstrated record of data-driven discovery, intense intellectual curiosity, and a passion for… more
- Evolent (Springfield, IL)
- …years of professional experience in claims-based healthcare analytics with a payer , provider, clinical vendor, managed care, or related healthcare consulting entity ... may be required as part of the application process. This is collected for compliance and security purposes and only reviewed if an applicant advances to the final… more
- AbbVie (Mettawa, IL)
- …the Value & Access Teams. Working to shape our overall access strategies, payer value propositions, and other critical deliverables to affiliate access teams, across ... broader VAT. + Create contracting guidance, to mitigate access risks and payer objections within the negotiation pathway, including evaluation of new access models.… more
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