- Public Consulting Group (Springfield, IL)
- …. Employee will be responsible for Medicaid , SNAP, WIC and other state government programs . They will be analyzing business requests, making ... + Experience with CMS, Medicaid , SNAP, WICK, and other state government programs **Supervisory Responsibility** + None **Working Conditions** + Remote… more
- Prime Therapeutics (Springfield, IL)
- …and drives every decision we make. **Job Posting Title** VP Government Programs - Medicare & Managed Medicaid (REMOTE) **Job Description** The Vice President ... Government Programs - Medicare & Managed Medicaid is...to execute the strategy + Establish key relationships with Government Program owners at the plans, and… more
- Prime Therapeutics (Springfield, IL)
- …passion and drives every decision we make. **Job Posting Title** North Carolina Medicaid Account Manager - Remote Raleigh, NC **Job Description** The Senior Account ... is responsible for providing complex level support for the North Carolina Medicaid business by driving communications, client-facing initiatives, and product and … more
- Intermountain Health (Springfield, IL)
- …Specialist is responsible for supporting and improving the quality performance of Government programs , particularly Medicare, with a strong focus on clinical ... is also tasked with identifying and engaging members in programs that enhance adherence and overall health outcomes, building...constructive and actionable feedback. + Represents the team in government meetings or special projects as assigned by a… more
- CenterWell (Springfield, IL)
- …to the Centers for Medicare and Medicaid Services (CMS) and other government agencies. The Program Management Lead, Offshore Coding Operations works on ... caring community and help us put health first** The Program Management Lead, Offshore Coding Operations conducts quality assurance...inquiries and issues. + May participate in coder education programs on coding compliance. + Follows state … more
- Humana (Springfield, IL)
- …the HOS program in all aspects of Humana's Medicare Advantage government business segment. + Lead and manage strategic initiatives, including the development of ... caring community and help us put health first** The Senior Program Delivery Professional HOS Strategic Initiatives strategically identifies enterprise partners to… more
- Humana (Decatur, IL)
- …members' needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families towards and facilitate interaction with resources ... procedures/regulations/professional standards with some interpretation. **Key Responsibilities** + Visits Medicaid members in their homes, Assisted Living Facilities (ALFs),… more
- CVS Health (Springfield, IL)
- …network issues, pharmacy and/or mental health parity. + Experience working with state and federal government agencies, healthcare laws and regulations. + ... for action to internal stakeholders and senior/executive management regarding federal/ state regulations in the healthcare industry. Serves as a subject… more
- Public Consulting Group (Springfield, IL)
- …public better. We provide the full spectrum of technology consulting services to help state and local agencies meet operational and program needs that enhance ... * Responsible for organizational migration, gap analysis, and coordination of program improvement, communications, and training activities related to MEMS Modules,… more
- Public Consulting Group (Springfield, IL)
- …better serve populations in need by making meaningful and lasting changes in government organizations. Services: + Program Consulting + Finance Consulting and ... and other tools. + Develop expertise in federal and state funding requirements, including Title IV-E, Medicaid ,...strategies. + Ability to interpret and apply federal and state policy to financial planning and program … more
- Sumitomo Pharma (Springfield, IL)
- …Disease products to ensure access for patients through various payers (commercial and government payers to include FFS and Managed Medicaid ) and remove ... escalations as needed to ensure timely access for patients + Engage with government stakeholders, including state and federal health agencies, to ensure… more
- CVS Health (Springfield, IL)
- …proposal environment, preferably within Medicaid Managed Care or other government -sponsored healthcare programs . + Proven ability to collaborate effectively ... implementing AI-driven solutions, developing and delivering training and onboarding programs , and developing reporting and analytics capabilities. They will also… more
- Humana (Springfield, IL)
- …trends. + Develop audit plans and tools for teams to ensure compliance with state contracts on performance metrics and to ensure member needs are met. + Develop ... skills to make an impact** **Required Qualifications** + **Must reside in the state of Illinois.** + An active, unrestricted, Registered Nurse (RN) license, Licensed… more
- Humana (Springfield, IL)
- …Excel and Outlook. + Experience with electronic information applications/software programs . **Preferred Qualifications** + Certified Case Manager (CCM). + Master's ... health or social service-related field. + Prior experience with Medicare & Medicaid recipients. + Previous experience with electronic case note documentation and… more
- CVS Health (Springfield, IL)
- …vendor management experience (preferably benefit administrators)** **5+ years of experience in government programs ( Medicaid , Medicare)** **Adept at problem ... for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed...and an **employee stock purchase plan** . + **No-cost programs for all colleagues** including wellness screenings, tobacco cessation… more
- Prime Therapeutics (Springfield, IL)
- …Word, and system operations (eg workflow processes and case management) + Government programs (Medicare) knowledge **Preferred Qualifications** + Contact Center ... of business to review the benefits of the MTM program . This position speaks with members to gather and...targeted population; for Medicare, is Centers for Medicare & Medicaid Services (CMS) compliance compliant + Utilize Prime's MTM… more
- Humana (Springfield, IL)
- …help us put health first** The Software Engineer 2 within Humana Government Business codes software applications based on business requirements. The Software ... skills and teamwork abilities. + Successfully receive interim approval for government security clearance (NBIS- National Background Investigation Service) + Our… more
- Prime Therapeutics (Springfield, IL)
- …management experience * PBM and/or health plan experience * Government Programs , Medicare Part D/B and/or Medicaid experience RxCLAIM experience **Minimum ... and other competing goals and risks, while still driving programs and initiatives to completion **Preferred Qualifications** * Project...status, or any other legally protected class under federal, state , or local law._ _ _ _We welcome people… more
- Evolent (Springfield, IL)
- …under current exclusion or sanction by any state or federal health care program , including Medicare or Medicaid , and is not identified as an "excluded ... + **This position is 100% Remote and can be completed from any state . Multiple opportunities for a flexible schedule and both part-time and full-time options… more
- Evolent (Springfield, IL)
- …under current exclusion or sanction by any state or federal health care program , including Medicare or Medicaid , and is not identified as an "excluded ... medical necessity guidelines, as well as other requests when providers, clients, or state laws require specialty reviews to be completed by the subject matter… more