Get new jobs by email
$163.42k - $324.25k
Overview Join HDR as the Construction Management Business Class Director (Water Business Group). The primary duty is to provide strategic national focus to position HDR as a preferred provider for construction services in the water infrastructure sector. The Director leads...CmsFull time$19.01 per hour
...maintain a level of high efficiency/productivity. Ensure adherence to call center turn around time requirements associated with DPW/CMS regulations. Take necessary steps to perform a complete and accurate evaluation of all non-formulary drug exception requests prior...CmsFor contractorsLocal areaHighmark Health
Springfield, IL3 days ago$100k - $231.54k
...highly regulated function, this role will also oversee delegated PBM functions, cross Medicare Pharmacy Organizational Compliance with CMS regulations as well as pharmacy functions required for various state contracts for our growing DSNP market. This role requires an...CmsHourly payFull timeTemporary workLocal areaRemote workFlexible hours$5 per hour
...Analytics PMP or CBIP certification; Agile/Scrum experience Experience with Medicaid programs, MMIS, and federal reporting (e.g., CMS 64, T-MSIS) Familiarity with tools such as Teradata, Informatica, SAS, Business Objects, and Microsoft Project Experience...CmsContract workCSpring
Springfield, ILa month ago- ...Kickback Statute, and False Claims Act, with a focus on PBM and managed care operations Experience engaging with regulatory bodies (e.g., CMS, OIG, state pharmacy boards) and contributing to internal or external policy initiatives Every employee must understand, comply with...CmsRemote jobContract workWork experience placementLocal areaVisa sponsorshipWork visa
$159.94k - $211.12k
...the WelbeHealth federal legislative and regulatory affairs function with Congress and the Centers for Medicare and Medicaid Services (CMS) Develop and implement meaningful engagement strategies to advance federal policy objectives, including effective stakeholder...CmsLocal area$14 - $23 per hour
...heavier items. EDUCATION AND LICENSES: HighSchooldiplomaorG.E.D. required. Must meet Center for Medicaid/Medicare Services (CMS)-approved state and/or national certification requirements within the required state or CMS timeline. Allappropriatestatelicensure...CmsHourly payWork experience placementImmediate startFRESENIUS MEDICAL CENTER
Springfield, IL1 day ago$193k - $242k
...concurrent review. Compliance & Quality: Partner with Legal, Compliance, and Policy teams to interpret and operationalize updates from CMS (e.g., Final Rules, model updates, guidance on medical record standards). Implement and monitor processes that ensure defensibility...Cms$150k - $224k
Who are we? Equinix is the world's digital infrastructure company, operating over 260data centers across the globe. Digital leaders harness Equinix's trusted platform to bring together and interconnect foundational infrastructure at software speed. Equinix enables ...CmsFull timeContract workFor contractorsEquinix
Springfield, IL1 day ago$223.8k - $313.1k
Overview Become a part of our caring community and help us put health first The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing home health, SNF, DME, dual Medicare/Medicaid and Waiver requests. The Medical Director provides...CmsFull timeTemporary workApprenticeshipRemote work$170k
...Depending on the nature of the case, telephonic peer to peer discussions may be required. The incumbent ensures compliance to NCQA, URAC, CMS, DOH, and DOL regulations at all times. In addition to utilization review, the incumbent participates as the physician member of the...CmsFor contractorsPrivate practiceWork at officeLocal area$88.3k - $167.8k
...based care models, and healthcare economics Knowledge of healthcare regulatory requirements (HIPAA, HITECH, 21st Century Cures Act, CMS programs) Experience with clinical terminologies (SNOMED CT, ICD-10, LOINC, RxNorm) and quality measures Understanding of healthcare...CmsWork at office$223.8k - $313.1k
...interpretation and determinations whether services provided by other healthcare professionals are in agreement with national guidelines, CMS requirements, Humana policies, clinical standards, and (in some cases) contracts. The ideal candidate supports and collaborates with...CmsFull timeTemporary workApprenticeshipRemote work- ...leadership, and multi-site operations ~ Experience with HomeCare HomeBase (HCHB) strongly preferred ~ In-depth knowledge of hospice CoPs, CMS regulations, and accreditation standards ~ Strong communication and organizational skills ~ Critical thinking and problem-solving...CmsDaily paidFull timePart timeLocal area
Gentiva
Springfield, IL6 hours agonew - ..., preferably including certifications Experience with website and related eCommerce platform experience with products like Sitecore, CMS etc Advanced knowledge of digital marketing strategies Education and Work Experience Bachelor’s degree in Marketing or related field...CmsWork experience placementWork at office
$150k
Overview At Verint, we believe customer engagement is the core of every global brand. Our mission is to help organizations elevate Customer Experience (CX) and increase workforce productivity by delivering CX Automation. We hire innovators with the passion, creativity, ...CmsContract workTemporary workFor contractorsLocal areaRemote workShift work$270.8k - $378.8k
...Program by overseeing in-home care delivery for bedbound and medically complex patients, ensuring alignment with national guidelines, CMS requirements, Humana policies, and clinical standards. Collaborate closely with primary care physicians and advanced practice...CmsFull timeTemporary workApprenticeshipRemote workFlexible hours$184.11k - $396.55k
...arrangements, and strategically expand VBS network. Support key state programs tied to healthcare transformation collaboratives and CMS 1115 waiver programs. Strong business acumen. Understands and proficient in sharing financial impacts, and market demands. Ability to...CmsHourly payFull timeContract workTemporary workLocal areaFlexible hours$8,281 per month
...application. Any questions on Reasonable Accommodations can be directed to Central Management Services Disability Resource Center at CMS.****@*****.*** or call (***) ***-**** for further information and to request or discuss an accommodation. Sponsorship...CmsPermanent employmentFull timeContract workH1bWork at officeImmediate startMonday to FridayFlexible hours$126.4k
...team keeps abreast of new developments in both the public and private reimbursement space, including new innovative models developed by CMS to ensure seamless integration and that the organization is ahead of the curve with regard to our strategy. Work in a Health...CmsContract workFor contractorsWork experience placementLocal area- ...and product access requirements Knowledge of regulations and laws governing the protection of patient identifying information, and CMS policies pertaining to access services Strategic business acumen and a data driven mindset Ability to align with brand priorities,...CmsWork at officeFlexible hours
$9,174 - $11,174 per month
...application. Any questions on Reasonable Accommodations can be directed to Central Management Services Disability Resource Center at CMS.****@*****.*** or call (***) ***-**** for further information and to request or discuss an accommodation. Sponsorship...CmsPermanent employmentFull timeWork experience placementH1bWork at officeImmediate startFlexible hoursNight shiftWeekend workAfternoon shift$10,833 per month
...application. Any questions on Reasonable Accommodations can be directed to Central Management Services Disability Resource Center at CMS.****@*****.*** or call (***) ***-**** for further information and to request or discuss an accommodation. Sponsorship...CmsPermanent employmentFull timeH1bWork at officeImmediate startMonday to FridayFlexible hours- ...annual enrollment files pertaining to the Teachers’ Retirement Insurance Program (TRIP) and the State Group Insurance Program. Work with CMS and the CMS third party enrollment administrator to correct any TRIP or State group insurance issues. Support the PAS...CmsFull timePart timeWork at office
$45.66k - $58.88k
...provided Continuing Legal Education Semi-monthly payroll *Health and Dental cost ranges: for single: $120.00 - $321.00 monthly; for family: $293.00 - $68.50 monthly For more information on benefits: visit cms.illinois.gov/benefits/stateemployee.html Government JobsCmsFull timePart timeWork at officeFlexible hours- ...tuning. ~3+ years of experience working with State Medicaid and CHIP agencies or equivalent healthcare payer ~ Basic understanding of CMS reporting requirements for Medicaid ~ Strong communication skills and ability to work directly with clients. ~ Bachelor’s or...CmsPermanent employment
- Claims Processor Creates and processes claims/invoices associated with patient care services and equipment provided via Memorial Home Services of Central Illinois, Inc. Analyzes and resolves claims/billing information and/or errors associated with private pay, commercial...CmsWork at office
- .../no direct supervision Preferred Qualifications Experience working with Data warehousing, Analytics, MMIS/MES, PERM, T-MSIS, CMS Federal Reporting or similar projects Understanding of CMS reporting requirements for Medicaid. Knowledge of health insurance,...CmsPermanent employment
- ...environment. Ensure product alignment with strategic business goals, value drivers, and regulatory requirements (e.g., HIPAA, CMS, and state laws), while balancing stakeholder needs and technical feasibility. Partner with portfolio stakeholders to collaboratively...CmsWork experience placementLocal areaImmediate startRemote workVisa sponsorshipWork visa
- ...in a manner that meets the specialized needs of the targeted population; for Medicare, is Centers for Medicare & Medicaid Services (CMS) compliance compliant Utilize Prime's MTM process management system to record member specific information Assess beneficiary...CmsWork experience placementLocal areaImmediate startWork from homeHome officeVisa sponsorshipWork visa
