• Medicaid Provider Hospital

    Humana (Springfield, IL)
    …our caring community and help us put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business ... the Pricer Business and System Support team responsible for administering complex Medicaid provider reimbursement methodologies. The associate will support… more
    Humana (12/02/25)
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  • Senior Provider Contracting Professional

    Humana (Springfield, IL)
    …Senior Provider Contracting Professional initiates, negotiates, and executes physician, hospital , and/or other provider contracts and agreements for an ... organization that provides health insurance. The Senior Provider Contracting Professional work assignments involve moderately complex to complex issues where the… more
    Humana (12/07/25)
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  • Dental Network Field Contractor

    Humana (Springfield, IL)
    …- 5 years of experience in negotiating managed care contracts with physician, hospital and/or other provider contracts. + Proficiency in analyzing, understanding ... part of our caring community and help us put health first** The Provider Contracting Professional 2 initiates, negotiates, and executes dental provider contracts… more
    Humana (12/09/25)
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  • Senior Care Manager (RN)

    Centene Corporation (Springfield, IL)
    HOSPITAL ON THE WEST SIDE OF CHICAGO TO SUPPORT MEDICARE AND MEDICAID ADMITTED MEMBERS WORKING WITH HOSPITAL STAFF TO FACILITATE DISCHARGE ... MONDAY - FRIDAY 8AM - 5PM WORKING FROM THE HOSPITAL BASED ON MEMBER CENSUS 3 - 4 DAYS...appropriate between the member and/or family/caregivers and the care provider team to ensure members are receiving adequate and… more
    Centene Corporation (12/05/25)
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  • Senior Claim Denial Prevention & Appeals…

    Oracle (Springfield, IL)
    …focus more on patient care by reducing administrative burden of clinical and reimbursement tasks such as charting, documentation, and coding by applying power of ... opportunities to prevent future denials, and ensure maximum appropriate reimbursement . This role is critical for financial recovery and...on experience preparing appeals for claim denials in the hospital and ambulatory setting + 3+ years hands on… more
    Oracle (12/11/25)
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  • Nurse Auditor 2

    Humana (Springfield, IL)
    …for services rendered is complete, compliant and accurate to support optimal reimbursement . The Nurse Auditor 2 work assignments are varied and frequently require ... in the state they reside. + Minimum of 2 consecutive years acute inpatient hospital care experience in critical, intensive care setting within the last 5 years (Not… more
    Humana (12/11/25)
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