- AmeriHealth Caritas (Detroit, MI)
- …care coordination for Medicare beneficiaries with complex medical, behavioral health, Long - Term Services & Supports (LTSS), and psychosocial needs. This ... roles serving individuals with chronic conditions or disabilities. + Strong understanding of Medicare -Medicaid Plan Long - Term Services and Supports (MMP… more
- Corewell Health (Dearborn, MI)
- …About the facility With 2 floors, 4 units, we are able to provide care for long term care residents and post-acute rehab patients. The first floor has 96 beds ... $1500.00 starting bonus! A Wing is a 58 bed Medicare /Medicaid unit that has residents with multiple clinical issues...you will be serving. We care for dementia residents, long term care and a rehab residents.… more
- Henry Ford Health System (Troy, MI)
- …design pharmacy cost management strategies that support affordability, member satisfaction, and long - term sustainability. + Serve as a subject matter expert on ... in 2026 and beyond. Position Summary The Director, Actuarial Services - Pharmacy / Part D is responsible for...Health Alliance Plan (HAP), with a primary focus on Medicare Part D and broader enterprise pharmacy strategy. This… more
- Molina Healthcare (Warren, MI)
- …Preferred Qualifications * Utilization management, care management, behavioral health and/or long - term services and supports (LTSS) non-clinical ... with National Committee for Quality Assurance (NCQA), Centers for Medicare and Medicaid Services (CMS), and state and federal guidelines and requirements. *… more
- Humana (Detroit, MI)
- …+ Experience with health promotion, coaching and wellness + Experience with Medicaid Long Term Care + Previous managed care experience + Bilingual- Spanish, ... holidays, volunteer time off, paid parental and caregiver leave), short- term and long - term disability, life...to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel,… more
- Humana (Detroit, MI)
- …+ Experience with health promotion, coaching and wellness + Experience with Medicaid Long Term Care + Previous managed care experience + Bilingual- Spanish, ... holidays, volunteer time off, paid parental and caregiver leave), short- term and long - term disability, life...to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel,… more
- Deloitte (Detroit, MI)
- …including value based care/ACO modeling + Knowledge of group insurance products including disability, long term care, etc. The wage range for this role takes ... December 15th, 2025.Work You'll Do + Provide strategic and technical consulting services to public sector clients + Support engagements focused on Medicaid… more
- United Therapeutics (Detroit, MI)
- …Teams + Advanced knowledge of medical insurance terminology + Knowledge of Centers of Medicare & Medicaid Services (CMS) policies and processes with expertise in ... of essential things like provider engagement, specialty pharmacies, patient services offerings, and the referral process. You want to...In addition, this role is eligible for the Company's short- term and long - term incentive programs.… more
- Molina Healthcare (Warren, MI)
- …Ownership** + Assists and executes tasks and projects to ensure Centers for Medicare & Medicaid Services (CMS) and State regulatory requirements are met ... health plan leadership and provides well-reasoned recommendations that support short- and long - term business goals. + Partners with Network to communicate… more
- Presbyterian Villages of Michigan (Chesterfield, MI)
- …3 years' experience with Medicare , Medicaid and Third Party billing in Long Term Care. Computer Skills Ability to operate a computer Proficient in ... vendor information, invoices, and payments. **Responsibilities** 1. Compute rates for services rendered to complete billing documents. 2. Review documents to compute… more
- Molina Healthcare (Detroit, MI)
- …PM EST (No weekends or Holidays) Provides support for care management/care coordination long - term services and supports specific activities and collaborates ... of MI. This position will support our MMP (Medicaid Medicare Population) that is part of the WAIVER team....services for members including behavioral health care and long - term services and supports (LTSS)… more
- Humana (Detroit, MI)
- …The Senior Provider Relations Professional is responsible for fostering positive, long - term relationships with network providers that participate in Michigan's ... holidays, volunteer time off, paid parental and caregiver leave), short- term and long - term disability, life...to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel,… more
- Molina Healthcare (Warren, MI)
- …+ Promotes integration of services for members including behavioral health care and long term services and supports, home and community to enhance the ... of MI. This position will support our MMP (Medicaid Medicare Population) that is part of the Community Well...of experience working with persons with disabilities/chronic conditions and Long Term Services & Supports.… more
- Molina Healthcare (Detroit, MI)
- …+ Promotes integration of services for members including behavioral health care and long term services and supports to enhance the continuity of care ... of MI. This position will support our MMP (Medicaid Medicare Population). This position will have a case load...of care across the continuum, including behavioral health and long term care, for members with high… more
- Molina Healthcare (Detroit, MI)
- …+ Promotes integration of services for members including behavioral health care and long term services and supports/home and community to enhance the ... of MI. This position will support our MMP (Medicaid Medicare Population) will be supporting DSNP. This position will...of care across the continuum, including behavioral health and long term care, for members with high… more
- Molina Healthcare (Warren, MI)
- …correctly in QNXT. The claims are reviewed to ensure that the configured services are correct. Maintain the audit workbooks and provide summation regarding the ... and converting these terms to configuration parameters. *Ability to interpret contract term agreements pertaining to Line of Business (LOB) and States for all… more
- Henry Ford Health System (Detroit, MI)
- …off with barcode scanning, controlled substance oversight, and billing including, Long Term Care (LTC) billing and Medicare D claim adjudication. + Serves as ... Detroit, MI, Henry Ford St. John Hospital is a full- service hospital with 24/7 emergency care and a Level...Henry Ford Health St. John Hospital + Department: Pharmacy Services General 001 + Shift: Day Job + Union… more