- Molina Healthcare (Warren, MI)
- …compliance by owning Molina's entire CMS Complaints Tracking Module (CTM) life cycle. As Director of CTM Oversight & Resolution you set the standards and ... related field (advanced degree a plus). **Experience** * 7+ years managing Medicare CTM, appeals & grievances, or related compliance functions-hands-on with CMS CTM… more
- Molina Healthcare (Warren, MI)
- …to members or authorized representatives in accordance with Centers for Medicare and Medicaid standards/requirements. * Provides direct oversight , monitoring ... and implements process improvements to achieve member/provider satisfaction or operational effectiveness/efficiencies which contribute to Molina Medicare 's… more
- Elara Caring (Bingham Farms, MI)
- … guidelines. + Assures compliance with the requirements of state licensure, Medicare certification, and any other applicable oversight agencies through policy ... have countless ways to make a difference as Branch Director . Being a part of something this great starts...you'll contribute to our success in the following ways: ** Operational Responsibilities:** + Organizes and directs the day-to-day operations… more
- Molina Healthcare (Warren, MI)
- …in collaboration with the Manager or Director . * Keeps Manager or Director apprised of operational issues, including staffing resources, program and system ... drug regimen review, patient education, and medical staff interaction), and oversight (establishing and measuring performance metrics with regard to patient… more
- Molina Healthcare (Warren, MI)
- …strategy and development with respect to adequacy, financial performance and operational performance, in alignment with Molina Healthcare's overall mission, core ... contracts. Issue escalations, network adequacy, Joint Operating Committees, and delegation oversight . Tighter knit proximity ongoing after contract. * In conjunction… more
- Henry Ford Health System (Troy, MI)
- …group tasked with implementing system-wide improvements within multi-disciplinary operational teams, ensuring optimal and compliant Mid-Revenue Cycle processes ... within value-based reimbursement models and initiatives. Reporting to the Director , Risk Adjustment and Value-Based Payment, the Program Manager is responsible for… more