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1 - 10 of 343 matches in 0.009 seconds
Temporary - Claims Processor - Veteran Affairs (VA (6928018)
Last Updated: 2019-10-21
Employer: WPS Health Solutions
Location: Chicago, IL

Role Summary:

The Temporary VA Claims Processor will process and develop Veteran Administration (VA) claims for missing information in accordance with VA regulations and guidelines.

  • Analyze claims to be determine if all claims filing requirements have been met.
  • Update line items to complete adjudication of claims.
  • Analyze claims to determine…
Senior Manager Network Programs (6928007)
Last Updated: 2019-10-21
Employer: Health Care Service Corporation
Location: Chicago, IL

Description:

Job Purpose:

This position is responsible for managing the functions of delegated utilization, case, and disease management oversight, physician quality oversight, and accreditation for commercial, exchange, and government HMO networks. Manages a professional nursing staff engaged in quality improvement activities and cost containment initiatives. Manages non-clinical staff engaged in…

Senior Actuarial Analyst (6928005)
Last Updated: 2019-10-21
Employer: Health Care Service Corporation
Location: Chicago, IL

Description:

Senior Actuarial Analyst

Job Purpose:

This position is responsible for

  • participating in implementation, maintenance and more detailed analysis of models, studies and systems which use actuarial principles for the purposes of pricing, underwriting, statistics, reserving, forecasting and other actuarial functions;
  • running and developing complicated models and performing detailed analysis…
IT Process Design & Governance Consultant (6928003)
Last Updated: 2019-10-21
Employer: Health Care Service Corporation
Location: Chicago, IL

Description:

As the healthcare industry continues to rapidly transform, our IT team conceives, develops and delivers impactful technology solutions to support access to quality, affordable healthcare for our members. We are driven by our collective company purpose: To do everything in our power to stand with our members in sickness…

IT Process Design & Governance Analyst (6928001)
Last Updated: 2019-10-21
Employer: Health Care Service Corporation
Location: Chicago, IL

Description:

As the healthcare industry continues to rapidly transform, our IT team conceives, develops and delivers impactful technology solutions to support access to quality, affordable healthcare for our members. We are driven by our collective company purpose: To do everything in our power to stand with our members in sickness…

Employee Relations Consultant (6928000)
Last Updated: 2019-10-21
Employer: Health Care Service Corporation
Location: Chicago, IL

Description:

Job Purpose: This position is responsible for identifying and mitigating enterprise wide risk through guiding business leaders on effective solutions for addressing corrective action, conflict resolution, and leaves and accommodations. The role will conduct investigations into employee concerns; assisting leaders in identifying solutions that will enable them to drive…

Data Scientist (6927996)
Last Updated: 2019-10-21
Employer: Health Care Service Corporation
Location: Chicago, IL

Description:

Job Purpose:

This position is responsible for employing advanced analytical techniques to create and drive adoption of data-based products and processes to add business value for internal and external customers. They will use data analysis, machine learning, predictive modeling, statistics, visualization, and other data science techniques to derive actionable…

Medical Management Specialist I - Govenment Progra (6927994)
Last Updated: 2019-10-21
Employer: Health Care Service Corporation
Location: Marion, IL

Description:

We are the Health Care Management division of HCSC – a team of dedicated nurses, doctors and other clinicians. Everything we do, and every decision we make, aims to help our members live their most healthy lives. We treat the whole person with integrated pharmacy, physical and mental health…

Senior Legal Assistant (6927993)
Last Updated: 2019-10-21
Employer: Health Care Service Corporation
Location: Chicago, IL

Description:

BASIC FUNCTION:
Under supervision, this position is responsible for performing administrative duties of a complex/confidential nature for Senior Legal Executives and attorneys in research and resolution activities; performs specialized and confidential duties which often require independent judgment; prepares routine to moderately complex documents, agreements and pleadings related to…

Pharmacy Underwriting Consultant (6927991)
Last Updated: 2019-10-21
Employer: Health Care Service Corporation
Location: Chicago, IL

Description:

Job Purpose:
This position is responsible for achieving profit, growth, service and expense objectives through the financial analysis and pricing of HCSCs RX business by quoting and rating proposals, projection renewal and the preparation of annual settlements and experience reporting. Under minimal supervision, the Group Underwriting Consultant serves as…

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