- Elevance Health (Dearborn, MI)
- …the afternoons. Candidates must be able to work Eastern Time Zone hours. The ** Medicare Medical Director ** is responsible for the administration of physical ... ** Medical Director - Medicare (Part-time)** Location: This role enables associates to work virtually full-time, with the exception of required in-person… more
- Molina Healthcare (Detroit, MI)
- **JOB DESCRIPTION** **Job Summary** The Medical Director for Specialty Medical Services & Market Performance will provide clinical expertise and support to ... quality improvement activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to… more
- Molina Healthcare (Detroit, MI)
- …Certification in Psychiatry **REQUIRED EXPERIENCE:** * 2 years previous experience as a Medical Director in clinical practice * 3 years' experience in ... State Medical License, free of sanctions from Medicaid or Medicare . **Preferred Experience** * Peer Review, medical policy/procedure development, provider… 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
- Elara Caring (Bingham Farms, MI)
- …this mission. This means you have countless ways to make a difference as Branch Director . Being a part of something this great starts by carrying out our mission ... pioneer in delivering unparalleled care, we need a Branch Director with commitment and compassion. Are you one of...+ Opportunities for advancement + Comprehensive insurance plans for medical , dental, and vision benefits + 401(K) with employer… more
- Corewell Health (Royal Oak, MI)
- Job Summary The Senior Director , Medical Education serves as a strategic partner to the Vice President of Academic Affairs and GME DIO to lead and oversee all ... education. The incumbent is accountable for developing and managing all medical education initiatives, contracts, and payments including Medicare reimbursements… more
- Bayer (Dearborn, MI)
- …minds to make a real difference, there's only one choice.** **Associate Director , Field Reimbursement, Oncology - Great Lakes Region** **Associate Director , ... HCPs and Office staff in navigating therapy Prior Authorizations (PAs), Medical Necessity documentation and therapy PA denial appeals. Develop collaborative working… more
- R1 RCM (Detroit, MI)
- …transform the patient experience and financial performance of hospitals, health systems and medical groups. We are the one company that combines the deep expertise ... sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our Director , Regulatory Compliance & Regulatory Affairs, you will be responsible… more
- Gentiva (Southfield, MI)
- …functions, including documenting referrals, new physicians and facilities, durable medical equipment (DME) pickup, Medicare patient eligibility, obtaining ... Senior** to join our team. You will report directly to the Executive Director or Administrator. You will be responsible for assisting branch leadership with… more
- ChenMed (Warren, MI)
- …housing managers, senior centers and related community providers to keep ChenMed/JenCare Medical Centers as their top provider choice for senior healthcare when ... handle additional sustained monthly production, developing better working relationships with Center Director , Director of Growth and other market leaders and… more
- Option Care Health (Farmington Hills, MI)
- …and delivering presentations within Option Care and externally with customers (ex. medical director , head of case management, executive c-suite individuals). ... oncology, or transplant. + Basic understanding of billing and reimbursement procedures for hospital, medical offices, and Medicare (B/D + benefits) as well as … more
- Trinity Health (Ypsilanti, MI)
- …area for productivity and adjust as needed. + Works closely with the medical directors and executive director to maintain a high-quality cost-effective programs ... performance, productivity, activity and budget. + Work with Executive Director of Michigan Heart to evaluates FTE needs in...assigned areas. + Implements measures to ensure compliance with Medicare , Federal Wage & Hour, OSHA and other regulations… 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, ... medical centers, urgent care centers, and employed physicians of...payor relationships including direct to employer relationships and commercial, Medicare Advantage, Medicaid HMO, and other governmental payors. 4.… more
- Henry Ford Health System (Detroit, MI)
- …Manager! GENERAL SUMMARY: Under the direction of the department director , the Education Specialist assesses, designs, and evaluates cost-effective, ... preventive service guidelines, clinical practice guidelines, behavior change theory, Medicare and Medicaid regulations and case management principles. Knowledge of… more
- Molina Healthcare (Detroit, MI)
- …knit proximity ongoing after contract. * In conjunction with Director /Manager, Provider Contracts, negotiates and analyzes, Complex Provider contracts including ... and/or language. Assists with cost control strategies that positively impact the Medical Care Ratio (MCR) within each region. * Advises Network Provider Contract… more