- Molina Healthcare (Warren, MI)
- …operation process designs and establishes procedures and techniques for operational standards. Confers with customers to define and resolve. ... **Knowledge/Skills/Abilities** Responsible for the oversight of regulatory compliance of Corporate Operations functions, including but not limited to performance of… more
- Molina Healthcare (Warren, MI)
- …on increased responsibility and adding value to the organization + Ensures strong operational processes are in place to deliver across all areas of responsibility + ... Provides oversight analyses of demographic data to support accurate Network Adequacy Reporting and Directory development. + Manage multiple resources and projects… 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
- Henry Ford Health System (Detroit, MI)
- …the nation's premier academic and integrated health systems, is seeking a Director of Corporate Reimbursement to lead critical financial functions that directly ... thoughtful integration of reimbursement practices into systemwide financial strategies. The Director will serve as a trusted partner to executive leadership,… more
- Molina Healthcare (Warren, MI)
- …Encounters is responsible for establishing enterprise-wide strategy, governance, and oversight of processes that track, evaluate, and submit encounter deletions ... for Medicare Advantage, ACA, and Medicaid lines of business. This...accuracy & completeness (ie, Encounter Production, Audit, Production Vendor Oversight ) for assigned lines of business. Responsible for increasing… more
- Integra Partners (Troy, MI)
- …Management (UM) Nurse Supervisor is responsible for providing direct leadership and oversight to the UM nursing team. This role ensures team performance, ... with organizational, state, and federal requirements. The Supervisor balances hands-on operational responsibilities with leadership duties, serving as both a mentor… 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