- Humana (Springfield, IL)
- **Become 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 work assignments involve moderately complex to complex issues...of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical … more
- Evolent (Springfield, IL)
- …in a non-clinical setting? Join our Utilization Management team as a Field Medical Director , Cardiovascular Specialist and use your expertise in interventional ... improvement, and clinical excellence. + **This position is 100% Remote and can be completed from any state. Multiple...per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to… more
- AbbVie (Mettawa, IL)
- … of Federal Contracting, Regional Director of Federal Accounts, and Director of Medicaid Contracting, including their respective AEs, to enhance account ... that solve serious health issues today and address the medical challenges of tomorrow. We strive to have a...contracting, retention, and pull-through performance across the DoD, VA, Medicaid , IHS and Kaiser channels. + Manage Channel Directors… more
- Option Care Health (Bannockburn, IL)
- …and brightest talent in healthcare. **Job Description Summary:** The Specialty Sales Director will develop and implement the Specialty business sales plan that ... geographic area of responsibility. It will be imperative for the Specialty Sales Director to work closely with the other Sales Directors and the Vice Presidents… more
- Humana (Springfield, IL)
- **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement ... will understand how to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately complex to… more
- Humana (Springfield, IL)
- **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement ... will understand how to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately complex to… more
- Humana (Springfield, IL)
- …home health, SNF, DME, dual Medicare/ Medicaid and Waiver requests. The Medical Director provides medical interpretation and determinations whether ... activities as assigned by the managing Medical Director ** Travel: While this is a remote ...a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at… more
- Humana (Springfield, IL)
- …Become a part of our caring community and help us put health first The Medical Director actively uses their medical background, experience, and judgement to ... to operationalize this knowledge in their daily work. The Medical Director 's work includes reviewing of all...of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical … more
- Humana (Springfield, IL)
- **Become a part of our caring community and help us put health first** The Medical Director relies on broad clinical expertise to review Medicare drug appeals ... (Part D & B). The Medical director work assignments involve moderately complex... management review organization such as Medicare Advantage, managed Medicaid , or Commercial health insurance + Current and ongoing… more
- Humana (Springfield, IL)
- …and build collaborative care models in their practices + Coordinates with the Medical Director to integrate the administration and management of behavioral and ... in this role collaborates closely with Clinical Services and the Chief Medical Officer(CMO) to integrate the day-to-day administration and strategic management of… more
- Humana (Springfield, IL)
- …of our caring community and help us put health first** The Director , Provider Contracting initiates, negotiates, and executes physician, hospital, and/or other ... and agreements for an organization that provides health insurance. The Director , Provider Contracting requires an in-depth understanding of how organization… more
- CenterWell (Springfield, IL)
- …a part of our caring community and help us put health first** A ** Director of Authorizations & Eligibility** is a senior revenue cycle leader responsible for the ... payer approvals to protect revenue integrity and patient access. The Director partners closely with clinical leadership, operations, finance, compliance, and IT,… more
- Humana (Springfield, IL)
- …our caring community and help us put health first** The Associate Director , Technology Solution Implementation delivers new technological solutions to meet business ... a specified scope while aligned to enterprise objectives. The Associate Director , Technology Solution Implementation requires a solid understanding of how… more
- Humana (Springfield, IL)
- …part of our caring community and help us put health first** The Director , Product Management Conceives of, develops, delivers, and manages products for customer use. ... The Director , Product Management requires an in-depth understanding of how...**Additional Information** **Humana Perks:** Full time associates enjoy: + Medical , Dental, Vision and a variety of other supplemental… more
- Humana (Springfield, IL)
- …caring community and help us put health first** The Associate Director , Database Administration manages and maintains all production and non-production databases. ... data storage, maintenance, access and security administration. The Associate Director , Database Administration requires a solid understanding of how organization… more
- Humana (Springfield, IL)
- …part of our caring community and help us put health first** The Director , Product Management for CenterWell Pharmacy Digital leads the strategic vision, development, ... business objectives, including accelerating growth in payor agnostic markets. Additionally, the Director will lead a team of Product Owners (POs) and Product… more
- Chiesi (IL)
- …Who we are looking for This is what you will do The National Account Director (NAD) contributes to the company's success by being one of the lead contacts with ... payer strategy by developing strategic relationships, along with securing formulary and/or medical policy access for Chiesi AIR products within the assigned National… more
- Humana (Springfield, IL)
- …of our caring community and help us put health first** The Associate Director of Cloud Infrastructure Operations is responsible for leading Humana's enterprise cloud ... at the intersection of operations, technology, and AI innovation. The Associate Director of Cloud Infrastructure Operations will drive the evolution of Humana's… more
- Humana (Springfield, IL)
- …of our caring community and help us put health first** The Associate Director , IT PMO is accountable for the overall effectiveness, maturity, and delivery outcomes ... enable predictable, high‑quality execution of complex initiatives. The Associate Director partners closely with Portfolio Management, Finance, Cybersecurity, and… more
- Humana (Springfield, IL)
- …a part of our caring community and help us put health first** The Director of Finance Portfolio Management, Strategy, & Special Projects is a key leadership role ... focused on continuously improving consumer experiences Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may… more