- CVS Health (Springfield, IL)
- …and can be based anywhere in the United States.** ** The Behavioral Health (BH) Medical Director (Special Investigations Unit) will be responsible for ... At CVS Health , we're building a world of health...approved by Legal. The expectation is that the BH Medical Director will have a high level...The expectation is that the BH Medical Director will have a high level of knowledge when… more
- Highmark Health (Springfield, IL)
- …Patient care (hospital, outpatient, or private practice) **Preferred** + 1 year in Medical Management in a Health Insurance Plan; strong knowledge of managed ... current clinical standards. The incumbent reviews escalated cases electronically and using Medical Policy criteria sets to evaluate the medical necessity and… more
- CVS Health (Springfield, IL)
- …Aetna sales teams, brokers and consultants supporting the Resource For Living and Behavioral Health businesses. You'll make an impact by: + Developing strategies ... ways every day. Aetna is recruiting for an Executive Director of Sales who will develop and manage a...selling strategies and supporting of retention strategies. + Supporting Behavioral Health sales with Aetna sales teams.… more
- Otsuka America Pharmaceutical Inc. (Springfield, IL)
- …education, and activation, ultimately improving patient access and adherence. The Director will work cross-functionally with medical affairs, market access, ... The Director , Consumer Marketing is responsible for leading the...deep expertise in direct-to-consumer (DTC) marketing, omnichannel engagement, and behavioral insights to create impactful and compliant consumer campaigns.… more
- Highmark Health (Springfield, IL)
- …and lines of business. This will require aligning new models to the health plan's strategic objectives based on a deep understanding of innovation and industry ... Advanced Analytics, Contracting and Provider Relations, Actuary, Finance, Highmark Health Solutions, Health Plan Operations. **ESSENTIAL RESPONSIBILITIES** +… more
- NASCO (Springfield, IL)
- …Cross Blue Shield Medical , Dental, and Vision Plans + Telehealthcare - for Medical and Behavioral visits + Generous PTO with buy/sell options + 9 Company ... **Overview** As Executive Director , Compliance you will lead and provide oversight...is designed to support the physical, mental, and financial health of our associates. We offer: **Physical and Mental… more
- CenterWell (Springfield, IL)
- …best care, when needed most, and for the lowest cost. We go beyond physical health - addressing the social, emotional, behavioral and financial needs that can ... part of our caring community and help us put health first** The IPA Coding Leader manages a diverse...identify and influence enhancements to technology to improve the medical coder experience. + Oversees coding operations by identifying… more
- The Cigna Group (Springfield, IL)
- …health -related benefits including medical , vision, dental, and well-being and behavioral health programs. We also offer 401(k) with company match, company ... Identification with client managers on identifying and pursuing vetted medical only clients to move to an integrated program...of benefits, with a focus on supporting your whole health . Starting on day one of your employment, you'll… more
- Evolent (Springfield, IL)
- …as required. + Entering data into a proprietary system generating cases for both the medical and behavioral health reviewers. These requests may be submitted ... also works with our clinical team, which includes our medical reviews: LVNs, LPNs, and RNs along with our... reviews: LVNs, LPNs, and RNs along with our behavioral health reviewers: LMSWs, LCSW, and LPCs,… more
- Cognizant (Springfield, IL)
- …Cognizant's TriZetto Elements suite of products can provide new value to health plan payers, by demonstrating deep expertise in Government healthcare (Medicare). The ... on market trends and solution offerings. . Work hand in hand with the Director of Elements HPC and other areas of the organization to determine, articulate, expand… more