Managed Care Jobs in Evanston (IL)
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Search Results - Managed Care Jobs in Evanston (IL)
Guidehouse-Evanston (IL)
Overview
As Director, Managed Care Advisory, you will drive revenue enhancement and strategic repositioning for healthcare clients through complex contract negotiations and high-impact care- and cost-focused strategies. You will lead and mentor...
CVS Health-Evanston (IL)
of experience of electronic documentation experience and Microsoft Office applications.
Preferred Qualifications
• Case management and discharge planning experience.
• Managed Care experience.
Education
• Bachelor's degree or non-licensed master level...
Cook County Sheriff-Evanston (IL)
Overview
In this role you will oversee delegates and vendors contracted with CountyCare, onboarding and monitoring contracts and relationships. You will manage an expanding managed care population for Medicaid and Medicare, strengthening...
Molina Healthcare-Evanston (IL)
/contract requirements
Key requirements
• At least 2 years in health care with 1 year in care management/managed care and 1 year with persons with disabilities, chronic conditions, substance use disorders, or LTSS
• Active and unrestricted professional...
Ankura Consulting Group-Evanston (IL)
Overview
In this role you support client engagements focused on regulatory, compliance, and operational matters for Medicare Advantage, Medicaid managed care, and ACA programs. You will perform regulatory research, analyze health plan data...
Merck Sharp & Dohme (MSD)-Evanston (IL)
Align account plans with payer and managed-care considerations to optimize access and reimbursement
• Deliver regional results and meet P&L targets
• Embed a customer-centric vision and motivate teams toward shared goals
• Contribute to national strategy...
Health Care Service-Evanston (IL)
Overview
In this role you will oversee assigned medical policies and programs and perform medical reviews while engaging with provider communities. You will lead initiatives to align care practices with managed care strategies and drive cost...
Huron Consulting Group-Evanston (IL)
and specialized engagements
• Advise Service Capture, CDI/Coding, and Managed Care teams on reimbursement implications
• Partner with data and analytics teams to identify, analyze, and apply client data for reimbursement modeling
• Serve as a subject matter expert...
Huron Consulting Group-Evanston (IL)
Strong understanding of managed care and payer/provider operations
• Experience with EDI and payer transactions (e.g., 834, 835, 837, 278)
• Ability to translate requirements into system configuration and CPT/HCPCS/ICD logic
• Experience supporting...
Xeris Pharmaceuticals-Evanston (IL)
trial, and managed care agreements
• Lead commercial negotiations with internal teams and third parties
• Identify legal and contractual risks and propose practical solutions
• Ensure compliance with applicable laws, regulations, and internal policies...
Health Care Service-Evanston (IL)
and the audit committee
• Provide leadership or guidance to audit staff as needed
Key requirements
• Bachelor degree
• 8 years of experience in health care, financial services operations, managed care, consulting, IT or related field
• 5 years of project...
Mercer Consulting-Evanston (IL)
or related experience in pharmacy managed care
• Superior analytical, strategic planning, communication, and listening skills
• Client-facing communication
• Leadership and mentoring
• Project management
• Pharmacy Benefits Management (PBM)
• Contract...
Health Care Service-Evanston (IL)
related projects
• Utilize MS Office and clinical/business databases for documentation and analytics
Key requirements
• Licensed Pharmacist
• 4 years of managed care pharmacy experience or 4 years of consulting in the pharmacy benefits industry...
Health Care Service-Evanston (IL)
Knowledge of medication use evaluation principles
• Ability to perform long periods of computer entry
• Skills to manage multiple priorities and communicate professionally for issue resolution
• 3 years of pharmacy practice experience
• Managed care...
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