- Molina Healthcare (Sterling Heights, MI)
- …and ensure adherence to business, system and regulatory requirements of Provider Data Management / Network Adequacy. **Knowledge/Skills/Abilities** + ... among multiple systems to ensure accurate reporting of the Provider Network across the enterprise. Validate data...Integrates work with other teams including New Markets team, Network Management , Product Teams, PDM and IT.… more
- Molina Healthcare (Sterling Heights, MI)
- …and system requirements of customers as it pertains to contracting, network management and credentialing. + **Knowledge/Skills/Abilities** + Strategically plans, ... **Job Description** **Job Summary** The Network Solutions Director is responsible for...solutions utilizing provider data such as the Provider Online Directory, Utilization Management , Customer Experience,… more
- Molina Healthcare (Sterling Heights, MI)
- …and system requirements of customers as it pertains to contracting, network management and credentialing. **Knowledge/Skills/Abilities** * Strategically plans, ... in developing and implementing appropriate Corrective Action Plans for submission of provider network files, etc. * Engages with IT and other departments to… more
- Molina Healthcare (Sterling Heights, MI)
- … and senior leadership/ management . * Communicates new strategies to corporate provider network leadership for input. * Utilize standardized system(s) to ... Georgia _** **Job Description** **Job Summary** Molina Health Plan Provider Network Contracting jobs are responsible for...including VBP program templates. Works with Legal and Corporate Network Management as needed to modify contract… more
- Molina Healthcare (Sterling Heights, MI)
- …must live in Michigan _** **Job Description** **Job Summary** Molina Health Plan Provider Network Contracting (Long Term Support Services, LTSS) jobs are ... business and system requirements of customers as it pertains to contracting, network management and credentialing. **Job Duties** This role negotiates assigned… more
- Cornerstone Caregiving (Chesterfield, MI)
- Operating Director for Chesterfield, MI Operating Director Full-Time Chesterfield, MI Apply Now Apply Now Job Summary Cornerstone Caregiving, the largest ... expand nationwide, we are searching for an exceptional Operating Director to lead this branch's growth. Supported by our...this branch's growth. Supported by our homebase and a network of Operating Directors, you will play a pivotal… more
- Molina Healthcare (Sterling Heights, MI)
- …as meeting or exceeding productivity standards. Educates and interacts with network and group providers and medical managers regarding utilization practices, ... guideline usage, pharmacy utilization and effective resource management . + Develops and implements a Utilization ...(QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to… more
- Molina Healthcare (Sterling Heights, MI)
- …as meeting or exceeding productivity standards. Educates and interacts with network and group providers and medical managers regarding utilization practices, ... guideline usage, pharmacy utilization and effective resource management . + Develops and implements a Utilization ...(QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to… more
- Molina Healthcare (Sterling Heights, MI)
- …and must live in Michigan _** **Job Description** **Job Summary** Molina Health Plan Provider Network Contracting jobs are responsible for the network ... Medical Care Ratio (MCR) within each region. * Advises Network Provider Contract Specialists on negotiation of...models. Seeks input on new reimbursement models from Corporate Network Management , legal and VP level engagement… more
- Molina Healthcare (Sterling Heights, MI)
- …+ Maintains contractual relationships with significant/highly visible providers. + Advises Network Provider Contract Coordinators and Specialists on negotiation ... provider and routine ancillary contracts. + Evaluates provider network and implement strategic plans with...models. Seeks input on new reimbursement models from Corporate Network Management and legal. + Educates internal… more
- Molina Healthcare (Sterling Heights, MI)
- **Job Description** **Job Summary** Molina Health Plan Provider Network Management and Operations jobs are responsible for network development, ... Strategy and Services. **Job Duties** + Lead Program Director team, managing all aspects of team's mission and...Responsible for the continued development and enhancement of the Provider Network Management and Operations… more
- Integra Partners (Troy, MI)
- The Utilization Management (UM) Nurse Supervisor is responsible for providing direct leadership and oversight to the UM nursing team. This role ensures team ... Nurse Team Lead's responsibilities include but are not limited to: + Provide day-to-day supervision of UM nurses, ensuring productivity, accuracy, and adherence to… more
- Meijer (Utica, MI)
- …participants have the potential to advance into roles such as Store Director - leading multimillion-dollar operations and large teams of several hundred team ... our doors more than 90 years ago with the goal of helping people provide for themselves and their family. Today we're a multi-billion dollar retailer with more… more
- Publicis Groupe (Troy, MI)
- …description** A division of Publicis Groupe, Publicis Digital Experience is a network of top-tier agencies designed to develop capabilities and solutions to enable ... growth and provide scaled access to the digital capabilities of Publicis...where ideas will work best. We are an expanding network with more than 5,000 employees, with agency brands… more