Top 22 Claims manager Jobs in Springfield, Il

Program Integrity Manager
CVS Health —Springfield, IL
- $54,300 - $145,860 a year
- Full-time
- Hybrid work
- 5 years
- Office
- Analysis skills
- Health insurance
- Dental insurance
Senior Manager, Pharma Support Services - Remote
Option Care Enterprises, Inc. —Springfield, IL
- $78,973.32 - $131,614.70 a year
- Full-time
- High school diploma or GED
- Travel
- Senior level
- Health savings account
- Health insurance
Quick Apply
10d
Manager, Patient Access Services.
Memorial Health —Springfield, IL
- $32.14 - $49.82 an hour
- Full-time
- Hospital
- Research
- Mid-level
Manager, Revenue Cycle and Auditing
Springfield Clinic —Springfield, IL
- $90,355.20 - $144,560.00 a year
- Full-time
- Microsoft Excel
- Bachelor of Science
- Office
Senior Manager, Pharma Support Services - Remote
Option Care Health —Springfield, IL
- $78,973.32 - $131,614.70 a year
- Full-time
- High school diploma or GED
- Travel
- Senior level
- Health savings account
- Health insurance
10d
MPPS Policy Deviations Senior Manager
CVS Health —Springfield, IL
- $67,900 - $182,549 a year
- Full-time
- Nursing
- 5 years
- Bachelor's degree
- Health insurance
- Dental insurance
7d
Product Manager, Fraud & Abuse
CVS Health —Springfield, IL
- $92,700 - $203,940 a year
- Full-time
- Mid-level
- 3 years
- Bachelor's degree
- Health insurance
- Dental insurance
Claims Manager
Troxell —Springfield, IL
- $50,000 - $70,000 a year
- Full-time
- Research
- Mid-level
- Office
- Disability insurance
- Health insurance
Quick Apply
Case Manager, Registered Nurse Field (Bureau County, IL)
CVS Health —Springfield, IL
- $66,575 - $142,576 a year
- Full-time
- Bilingual
- Nursing
- Microsoft Outlook
- Health insurance
- Dental insurance
Billing and Business Office Manager-Concordia Village-FT/Days
EverTrue —Springfield, IL
- $27.00 - $43.25 an hour
- Full-time
- Microsoft Excel
- Microsoft Outlook
- Mid-level
- Paid jury duty
- Health insurance
Quick Apply
6h
Sr. Mgr, Business Analytics - Zinc
CVS Health —Springfield, IL
- $75,400 - $182,549 a year
- Full-time
- 5 years
- Microsoft Office
- SQL
- Health insurance
- Dental insurance
Specialty Pharmacy Manager
Optum —Springfield, IL
- $112,700 - $193,200 a year
- Full-time
- Pass drug screening
- Outpatient experience
- Supervising experience
Quick Apply
6d
Manager, Medical Economics
CVS Health —Springfield, IL
- $54,300 - $145,860 a year
- Full-time
- Remote
- Mid-level
- 3 years
- SQL
- Health insurance
- Dental insurance
17h
Senior Manager, Medical Economics
CVS Health —Springfield, IL
- $67,900 - $199,144 a year
- Full-time
- 5 years
- SQL
- Bachelor's degree
- Health insurance
- Dental insurance
17h
Group Product Manager, Digital Commerce & Marketing Products
CLEAResult Consulting Inc. —Springfield, IL
- $141,900 - $212,900 a year
- Full-time
- 7 years
- Product management
- Mentoring
- Health insurance
- Dental insurance
Quick Apply
Account Manager- Commercial Insurance
Insurance Office of America, Inc. —Springfield, IL
- $45,000 - $75,000 a year
- Full-time
- Mid-level
- Leadership
- 2 years
- Paid holidays
- Health insurance
Quick Apply
Technical Service Manager
Rentokil North America —Springfield, IL
- $73,000 - $111,000 a year
- Full-time
- Sanitation
- Office
- Ability to climb stairs
- Paid holidays
- Disability insurance
Quick Apply

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claims manager jobs near springfield, il

Program Integrity Manager

CVS Health -
Springfield, IL

Apply Now

Job Details

Full-time
$54,300 - $145,860 a year

Benefits

Health insurance
Dental insurance
Paid time off
Vision insurance

Qualifications

Cross-functional collaboration
Cross-functional communication

Full Job Description

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.

Position Summary
The Program Integrity Manager serves as a key leader supporting Medicaid Program Integrity, Payment Integrity, and Special Investigations Unit (SIU) activities. This role is responsible for ensuring compliance with state and federal requirements, supporting fraud, waste, and abuse (FWA) prevention efforts, overseeing regulatory and contractual obligations, coordinating reporting and audit activities, and partnering with internal and external stakeholders to promote operational effectiveness and program integrity. The position works closely with health plan leadership, compliance, SIU, payment integrity vendors, and operational teams to support initiatives that improve performance, strengthen oversight, and ensure compliance with applicable requirements.

Required Qualifications

5+ years experience in Program Integrity, Payment Integrity, Special Investigations, Healthcare Compliance, Fraud, Waste and Abuse (FWA), Claims Operations, Healthcare Operations, or a related field.
Knowledge of healthcare regulatory and compliance requirements.
Strong analytical, organizational, communication, and problem-solving skills.
Ability to manage multiple priorities and work effectively in a collaborative environment.
Experience building relationships and working with cross-functional teams and external stakeholders.

Preferred Qualifications

Experience supporting Medicaid managed care programs.
Experience with regulatory reporting, audits, compliance initiatives, or operational oversight activities.
Experience working with SIU investigations, fraud prevention programs, vendor management, or payment integrity operations.
Knowledge of healthcare claims, provider reimbursement, payment accuracy, and program integrity practices.

Education

Bachelor's degree or equivalent combination of education and experience.

**We support a hybrid work environment. If selected and you live near a suitable work location, you may be expected to comply with the hybrid work policy. Under the policy, all hires for in-scope populations should be placed into a hybrid or office-based location, working onsite three days a week.
Aetna Service Operations office/hub locations will be discussed with the selected candidate.

Anticipated Weekly Hours

Time Type

Full time

Pay Range

The typical pay range for this role is:

$54,300.00 - $145,860.00

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Great benefits for great people

We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.

This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.

Additional details about available benefits are provided during the application process and on Benefits Moments.

We anticipate the application window for this opening will close on: 08/15/2026

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Apply Now

Refine Your Search

claims manager jobs in springfield, il

Program Integrity Manager

Senior Manager, Pharma Support Services - Remote

Manager, Patient Access Services.

Manager, Revenue Cycle and Auditing

Senior Manager, Pharma Support Services - Remote

MPPS Policy Deviations Senior Manager

Product Manager, Fraud & Abuse

Claims Manager

Case Manager, Registered Nurse Field (Bureau County, IL)

Billing and Business Office Manager-Concordia Village-FT/Days

Sr. Mgr, Business Analytics - Zinc

Specialty Pharmacy Manager

Manager, Medical Economics

Senior Manager, Medical Economics

Group Product Manager, Digital Commerce & Marketing Products

Account Manager- Commercial Insurance

Technical Service Manager

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I want to receive the latest job alert for claims manager in springfield, il

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5+ years experience in Program Integrity, Payment Integrity, Special Investigations, Healthcare Compliance, Fraud, Waste and Abuse (FWA), Claims Operations, Healthcare Operations, or a related field.

Knowledge of healthcare regulatory and compliance requirements.

Strong analytical, organizational, communication, and problem-solving skills.

Ability to manage multiple priorities and work effectively in a collaborative environment.

Experience building relationships and working with cross-functional teams and external stakeholders.

Preferred Qualifications

Experience supporting Medicaid managed care programs.

Experience with regulatory reporting, audits, compliance initiatives, or operational oversight activities.

Experience working with SIU investigations, fraud prevention programs, vendor management, or payment integrity operations.

Knowledge of healthcare claims, provider reimbursement, payment accuracy, and program integrity practices.

Education

Bachelor's degree or equivalent combination of education and experience.

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