- CVS Health (IL)
- …And we do it all with heart, each and every day. **Position Summary** The ** Medicare Compliance Consultant ** is a compliance role that supports ... partnership with - and under the direction of - the health plan, Medicare Compliance Officer, and other team members, this position will help develop and… more
- Prime Therapeutics (Springfield, IL)
- …passion and drives every decision we make. **Job Posting Title** Pharmacy Network Consultant Sr - Remote **Job Description** The Pharmacy Network Consultant Sr ... pharmacy networks composition to assess network adequacy, contracting gaps and compliance with regulations + Represent Network Management department in audits and… more
- The Joint Commission (Oakbrook Terrace, IL)
- …from the field, analysis of periodic performance reviews, evidence of standards compliance reports, complaints, and Medicare out-of- compliance reports. + ... inductive reasoning skills to determine a health care organization's degree of compliance with applicable standards and functionality of care delivery systems. Field… more
- AccentCare, Inc. (Rosemont, IL)
- Overview Hospice Care Consultant Location: Rosemont, IL Position: Hospice Care Consultant Position Type: Full-Time Remote/Virtual Position: No Coverage Area: ... non acute facilities Find Your Passion and Purpose as a Hospice Care Consultant Salary: 85,000-110,000 (based on experience) What You Need to Know Reimagining Your… more
- Humana (Springfield, IL)
- …Adhere to established guidelines and procedures to ensure consistency and compliance . **Potential Duties** + Advocate for our agile development approach and ... with the organization's strategy and long-term goals. + Serve as a consultant to application teams, guiding them in creating enterprise-grade applications that… more
- CVS Health (IL)
- …and maintaining a deep understanding of PBM financial levers within Commercial, Medicaid, Medicare Part D, and Public Exchange lines of business. + Conduct market ... pricing consultation and strategy in an evolving regulatory environment to ensure compliance . + Exercising sound business judgment to achieve proper balance between… more
- Humana (Springfield, IL)
- …through collaboration with diverse stakeholders across the enterprise, including legal, compliance , education, and IT. In this role, you will contribute to ... the enterprise, including model risk assessments, fairness evaluations, and compliance with ethical and regulatory standards. Champion transparency, accountability,… more
- ChenMed (Berwyn, IL)
- …mission-driven, primary care organization, is currently one of the most successful full-risk Medicare Advantage providers in the nation and has a vision to be ... acts as a health coach, rather than just a consultant for sickness, by helping patients set short and...with the applicable managers and medical directors to ensure compliance with guidelines along with participating in risk and… more
- ChenMed (Berwyn, IL)
- …mission-driven, primary care organization, is currently one of the most successful full-risk Medicare Advantage providers in the nation and has a vision to be ... acts as a health coach, rather than just a consultant for sickness, by helping patients set short and...with the applicable managers and medical directors to ensure compliance with guidelines along with participating in risk and… more
- Humana (Springfield, IL)
- …communications and processes + Relevant SAFe certificationssuch as SAFeProgram Consultant , SAFe Lean Portfolio Management, andSAFe Agilist **Additional Information** ... to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
- CVS Health (Chicago, IL)
- …models. You can have life-changing impact on our members who are enrolled in Medicare and Medicaid and present with a wide range of complex health and social ... chronically ill members/clients across the continuum of care that can include consultant referrals, home care visits, the use of community resources, and alternative… more