- Elevance Health (Dearborn, MI)
- **Medical Director - Medicare (Part-time)** Location: This role enables associates to work virtually full-time, with the exception of required in-person training ... be able to work Eastern Time Zone hours. The ** Medicare Medical Director ** is responsible for the...creating a culture that is designed to advance our strategy but will also lead to personal and professional… more
- R1 RCM (Detroit, MI)
- …enhancing the patient experience. As the Government Navigation Services (GNS) Business Development Director , you will focus on engaging and targeting new Tier 1 and ... in addition to prospecting and networking initiatives, the GNS Business Development Director will partner with the Business Development teams of in-house and… more
- Molina Healthcare (Detroit, MI)
- **Job Description** **Job Summary** The National Program Director - Value-Based Care is a strategic leadership role responsible for the development, implementation, ... evolution of value-based care (VBC) programs across all lines of business-Medicaid, Medicare , and Marketplace. This role is critical in driving clinical and… more
- R1 RCM (Detroit, MI)
- …sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our Director , Regulatory Compliance & Regulatory Affairs, you will be responsible ... establishing, maintaining, and reviewing compliance risk controls and compliance strategy throughout the organization. Every day you routinely interact with… more
- Molina Healthcare (Detroit, MI)
- …* Develops and maintains a standard provider reimbursement strategy consistent with reimbursement tolerance parameters (across multiple specialties/geographies). ... and/or regulatory requirements. * Monitors and reports network adequacy for Medicare and Medicaid services. * Develops strategies to improve EDI/MASS rates.… more
- Option Care Health (Farmington Hills, MI)
- …**Job Description Summary:** Under the direction of the Regional Sales Director , Health Systems Solutions (RSD, HSS), manages the development and execution ... Develops appropriate business plans for new initiatives addressing market entry strategy , financial analysis and projected costs, timelines, and necessary resources.… more
- Henry Ford Health System (Troy, MI)
- GENERAL SUMMARY: Reporting to the Director - Managed Care Contracting, this position is responsible for managing the payor contracting functions for the hospitals, ... all payor relationships including direct to employer relationships and commercial, Medicare Advantage, Medicaid HMO, and other governmental payors. 4. Routinely… more
- Molina Healthcare (Detroit, MI)
- …Plan Provider Network Contracting jobs are responsible for the network strategy and development with respect to adequacy, financial performance and operational ... knit proximity ongoing after contract. * In conjunction with Director /Manager, Provider Contracts, negotiates and analyzes, Complex Provider contracts including… more