- CVS Health (Springfield, IL)
- … Director UM decisions. If specifically assigned to one business segment (ie, Medicare clients), each director will become sufficiently skilled in various UM ... a share of special clinical investigations and research as requested by the Senior Medical Director , Medical Affairs. These projects can include brief reviews… more
- Humana (Springfield, IL)
- …a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The Medical Director ... (10) Years of Clinical Practice with Older Adults (Medical Director ) is dedicated full time to the Indiana Pathways...) is dedicated full time to the Indiana Pathways program to assist the Utilization Management, Care Management, and… more
- Humana (Springfield, IL)
- …of our caring community and help us put health first** The Associate Director , Value-Based Solutions will be responsible for leading the operational performance of ... Horizon's specialty value-based payment (VBP) model portfolio. The Associate Director will oversee a team of direct reports to...and existing VBP models. + Ensure data integrity in program administration for new value-based program . +… more
- The Joint Commission (Oakbrook Terrace, IL)
- …**GENERAL SUMMARY:** The Team Lead for Standards Interpretation Group will assist the Senior Director of Standards Interpretation and Senior Associate ... programs. Combines systems analysis skills with in-depth general and program -specific knowledge to evaluate health care organizations' compliance and ability… more
- Humana (Springfield, IL)
- …of our caring community and help us put health first** The Associate Director , Business Intelligence will be responsible for leading the operational performance of ... Overseeing a team of highly specialized professional associates, the Associate Director will implement operational processes to support payments and reporting for… more
- Walgreens (Deerfield, IL)
- …or discuss complex reimbursement systems and flow of the healthcare dollar ( Medicare Part BD, ACOs, GPOs, Hospitals, etc) **Job Responsibilities** + **Business ... alliance partners outside the company to increase business. Provides clinical program support ensuring accounts are effectively managed. Initiates and participates… more
- Gentiva (Springfield, IL)
- …Care Manager** to join our team. You will report directly to the Executive Director , Administrator, or Senior Patient Care Manager. You will be responsible for ... hospice site, administering the clinical aspects of the hospice program and for ensuring the provision or quality of...Managing the site in the absence of the Executive Director , Administrator, or Senior /Executive Patient Care Manager.… more
- Humana (Springfield, IL)
- …first** The Sr. Manager, Lead Category Manager will report directly into the Director of IT Procurement and will lead the development of category strategies, design ... minimize risk to Humana. + Drive corporate compliance to the preferred-supplier program via end-user change management and communications programs. + Work closely… more