- CVS Health (Springfield, IL)
- …convenient and affordable. **Position Summary** The Business Configuration Sr. Coordinator is responsible for the operational development and performance of ... prior authorization criteria to include configuration data, clinical protocols, and medical notification documents within CVS Health's Medical Claims and Prior Authorization platform (Novologix). The position works closely with other business teams to manage… more
- CVS Health (Springfield, IL)
- …Responsible for managing to resolution appeal scenarios for all products, which contain multiple issues and may require coordination of responses from multiple ... business units. Appeals are typically more complex and may require outreach and deviation from standard processes to complete. Develop into a subject matter expert by providing training, coaching, or responding to complex issues. May have contact with outside… more
- CVS Health (Springfield, IL)
- …Minimum of 2 years of Medical Billing Experience or health plan claims adjudication experience Preferred Qualifications 3-5 Years of Medical Billing experience or ... Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world.… more
- Highmark Health (Springfield, IL)
- …:** **JOB SUMMARY** This job captures all inbound phone inquires for utilization management review from providers and pharmacies. The incumbent assesses the verbal ... request, critically thinks through the inquirer's concerns which may require research to fulfill the call, such as verifying benefit coverage, creation of a prior authorization case in Highmark's Utilization Management system for Prior Authorization clinical… more
- HomeSafe Alliance (Springfield, IL)
- **Title:** Lead Booking Coordinator (HHG Military Move) **_HomeSafe Alliance_** is the single global household goods movement manager of over 300,000 Military ... . HomeSafe Alliance is seeking an experienced and highly motivated Lead Booking Coordinator to oversee and support the booking team for military household goods… more
- Cardinal Health (Springfield, IL)
- …information. + Escalates highly complex and difficult issues as needed to senior team members and Individualize Care leadership. **_Qualifications_** + 1-3 years of ... receives detailed instruction on new assignments + Consults with supervisor or senior peers on complex and unusual problems **TRAINING AND WORK SCHEDULES:** Your… more
- Cardinal Health (Springfield, IL)
- …information. + Escalates highly complex and difficult issues as needed to senior team members and Individualize Care leadership. **_Qualifications_** + 1-3 years of ... receives detailed instruction on new assignments + Consults with supervisor or senior peers on complex and unusual problems **TRAINING AND WORK SCHEDULES:** Your… more
- Cardinal Health (Springfield, IL)
- …receives detailed instruction on new assignments + Consults with supervisor or senior peers on complex and unusual problems **_Responsibilities_** The Case Manager ... supports patient access to therapy through Reimbursement Support Services in accordance with the program business rules and HIPAA regulations. This position is responsible for guiding the healthcare providers through the various process steps in support of… more
- Centene Corporation (Springfield, IL)
- …Montgomery, Menard, Logan, Christian, Sangamon, Mason.** **Position Purpose:** Works with senior care management team to support care management activities and the ... teams assigned to members to ensure services are delivered by the healthcare providers and partners and continuity of care/member satisfaction is achieved. Serves as a liaison alongside care managers and providers to ensure proper coordination of care for… more
- Cardinal Health (Springfield, IL)
- …receives detailed instruction on new assignments + Consults with supervisor or senior peers on complex and unusual problems **Responsibilities** + Responsible for ... handling inbound calls, with ability to determine needs and provide one call resolution. + Manage workload of inbound faxes (if applicable) + Investigate and resolve patient/physician inquiries and concerns in a timely manner + Enter detailed information into… more
- Prime Therapeutics (Springfield, IL)
- …between Sales, Operations, and other stakeholders + Serve as primary coordinator and project manager for Prime's highest visibility sales activities, including ... organization + Develop, execute and maintain effective sales reporting cadence for Senior Leadership + Document Prime's sales processes, develop tools to support… more
- Gentiva (Springfield, IL)
- …Plans + Wellness Program and Resources including: + A dedicated Accolade Care Coordinator for personalized care management support of all your healthcare needs + ... Report directly to the Administrator, Executive Director or Patient Care Manager Senior and function under the direction, instruction and supervision of the… more
- Gentiva (Springfield, IL)
- …+ Reportdirectly to the Administrator, Executive Director or Patient Care Manager Senior and will maintain primary control and professional management of each ... Plans + Wellness Program and Resources including: + A dedicated Accolade Care Coordinator for personalized care management support of all your healthcare needs +… more