- McLaren Health Care (Lansing, MI)
- …**Essential Functions and Responsibilities:** 1. Plans, directs, controls and evaluates patient care nursing operations in collaboration with the Chief ... goals. Assists in establishing standards of performance, quality assurance and control, and patient care delivery. 2. Serves as a resource and representative by… more
- Gentiva (Okemos, MI)
- …as primary liaison between physician, patient /family and hospice team. + Provide direct patient care services to hospice patients and supportive care ... a Hospice RN/ RN Case Manager, you will:** + Reportdirectly to the Administrator, Executive Director or Patient Care Manager Senior and will maintain primary… more
- Gentiva (Okemos, MI)
- …Therapist reports to the Administrator, Executive Director , or Patient Care Manager. Responsible for providing service to patients who have speech and ... Gentiva family - an industry leader in hospice, palliative, home health, and personal home care . Our place is by the side of those who need us, offering physical,… more
- Otsuka America Pharmaceutical Inc. (Lansing, MI)
- …This role will oversee nurse case managers, ensuring high-quality patient care and operational excellence in our support services , inclusive of medication ... in our support services while ensuring the highest standards of patient care and operational efficiency. **Competencies** **Accountability for Results -**… more
- Humana (Lansing, MI)
- …and judgement to make determinations whether requested services , requested level of care , and/or requested site of service should be authorized. All work ... DO degree + **Valid Florida Medical license** + 5+ years of direct clinical patient care experience post residency or fellowship, which preferably includes some… more
- McLaren Health Care (Lansing, MI)
- …evaluations and competencies are current. Reviews content of evaluations if not completed by Patient Care Services Manager. 14. Maintains compliance with all ... Summary:** Has responsibility for 24-hour accountability for the management of assigned patient care unit(s)/function(s). In this capacity, will accomplish the… more
- Humana (Lansing, MI)
- …and judgement to make determinations whether requested services , requested level of care , and/or requested site of service should be authorized. All work ... your skills to make an impact** **Responsibilities** The Medical Director provides medical interpretation and determinations whether services...or DO degree + 5+ years of direct clinical patient care experience post residency or fellowship,… more
- Humana (Lansing, MI)
- …and judgement to make determinations whether requested services , requested level of care , and/or requested site of service should be authorized. All work ... services and equipment, within their scope. The Medical Director may speak with contracted external physicians, physician groups,...or DO degree + 5+ years of direct clinical patient care experience post residency or fellowship,… more
- Evolent (Lansing, MI)
- …accountability as we solve complex business problems. **Collaboration Opportunities:** The Director , Actuarial Services utilizes and develops analytical tools to ... and costly health conditions. Working across specialties and primary care , we seek to connect the pieces of fragmented...as oncology and cardiology. We are advocates for creating patient value and demonstrate this by ensuring that our… more
- Humana (Lansing, MI)
- …**Required Qualifications** + MD or DO degree + 5+ years of direct clinical patient care experience post residency or fellowship, which preferably includes some ... DME, skilled nursing facility and waiver requests. The Medical Director provides medical interpretation and determinations whether services...serve to achieve their best health - delivering the care and service they need, when they… more
- Evolent (Lansing, MI)
- …Reviewer (Interventional Cardiologist)** Are you ready to make a meaningful impact on patient care in a non-clinical setting? Join our Utilization Management ... We Offer:** + A meaningful way to contribute to patient care beyond the clinical setting. +...Inspector General of the Department of Health and Human Services or the General Service Administration (GSA),… more
- Otsuka America Pharmaceutical Inc. (Lansing, MI)
- …(OPH) is the next step in our evolution. We are a health technology and services organization on a mission. And that mission is to get people the right interventions ... of personal connection and deep, data-driven understanding of the patient condition. OPH is part of Otsuka Holdings. Leverage...our part to fix some of the fragmentation in care delivery. The time is now. **What you will… more
- Humana (Lansing, MI)
- …for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to ... our caring community and help us put health first** The Corporate Medical Director (CMD) relies on medical background to review health claims and preservice appeals.… more
- Humana (Lansing, MI)
- …for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to ... our caring community and help us put health first** The Corporate Medical Director relies on medical background and reviews health claims and preservice appeals. The… more
- Bayer (Lansing, MI)
- …approval requests. This position is also responsible for collaboration with the Bayer Patient Support Services Team, Market Access Field Teams, Bayer AGMs, SCs ... minds to make a real difference, there's only one choice.** **Associate Director , Field Reimbursement, Oncology - Great Lakes Region** **Associate Director ,… more
- Highmark Health (Lansing, MI)
- …AI-powered products, including a core administrative platform, modular utilization and care management solutions, patient -focused digital products, and clinical ... data exchange capabilities, as well as outsourced technology and BPO services . The Director is a strategic thinker with experience in selling Healthcare… more
- Trustmark (Lansing, MI)
- …to our colleagues, clients and communities. **About the role** Regional Sales Director - Southern California Trustmark Voluntary Benefits is a division of Trustmark ... to providing quality voluntary benefits including Universal Life with Long Term Care , Critical Illness, Disability and Wellness for employers with 100 or more… more
- Evolent (Lansing, MI)
- …specifically, differences between institutional vs professional billing and various sites of care / service + Familiarity with value-based care and utilization ... and costly health conditions. Working across specialties and primary care , we seek to connect the pieces of fragmented...Stay for the culture. **What You'll Be Doing:** The Director of Performance Analytics - **Oncology and Member** focus… more
- CenterWell (Lansing, MI)
- …of Humana's Primary Care Organization, which includes CenterWell Senior Primary Care , Conviva's innovative, value-based approach means each patient gets the ... + MS-DRG auditing or APR auditing experience + Acute in- patient and/or outpatient coding experience + Must be passionate...serve to achieve their best health - delivering the care and service they need, when they… more
- Highmark Health (Lansing, MI)
- …or Public Health **EXPERIENCE** **Required** + 5 years in Clinical, Direct Patient care (hospital, outpatient, or private practice) **Preferred** + 1 ... to evaluate the medical necessity and appropriateness of the requested treatment of service . Depending on the nature of the case, telephonic peer to peer discussions… more