- Elevance Health (Dearborn, MI)
- ** Medicare Medical Director ** Location: This role requires associates to be in-office 3 days per week, fostering collaboration and connectivity, while ... Candidates must be able to work Eastern Time Zone hours. The ** Medicare Medical Director ** is responsible for the administration of physical and/or… more
- Molina Healthcare (Detroit, MI)
- …quality improvement activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to ... Medicare , Medicaid, NCQA and other regulatory requirements. + Reviews...experience, including: + 2 years previous experience as a Medical Director in a clinical practice. +… 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
- Genesis Healthcare (Ann Arbor, MI)
- …Powerback is the place for you. **Why Powerback?** + **Benefits:** We offer Medical , Dental, and Vision plans to Full-Time and Part-Time team members. + **Support ... expertise with our Clinicians in Action professional development program. Responsibilities The Director of Rehab PT is responsible for the efficient management of… more
- Molina Healthcare (Detroit, MI)
- …with the standards and requirements established by the Centers for Medicare and Medicaid **Knowledge/Skills/Abilities** * Leads, organizes, and directs the ... to members or authorized representatives in accordance with Centers for Medicare and Medicaid standards/requirements. * Provides direct oversight, monitoring and… more
- Bayer (Farmington, 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
- Henry Ford Health System (Clinton Township, MI)
- GENERAL SUMMARY: Under the direction of VP Operations, CNO, the Regional Director of Case Management is responsible for the development, implementation, and/or ... of preventive service guidelines, clinical practice guidelines, behavior change theory, Medicare and Medicaid regulations and case management principles. . Knowledge… more
- Molina Healthcare (Detroit, MI)
- …ideally suited for candidates living in the Eastern Time Zone. Regional Director Quality Solutions (QS) is responsible for contributing to the strategic performance ... + Serves as the subject matter expert for all, Medicaid / Medicare / Marketplace quality, and data acquisition functions to ensure participants understands… more
- Integra Partners (Troy, MI)
- …+ Be prepared to appeal or correct CRT claims in compliance with Medicare , Medicaid, and commercial insurance guidelines. + Ensure all required documentation (eg, ... prescriptions, prior authorizations, therapist evaluations, and medical necessity justifications) is included with claims. + Verify coding accuracy, including HCPCS… 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
- Henry Ford Health System (Detroit, MI)
- …technical and professional component billing. GENERAL SUMMARY: Reporting to the Director , Laboratory Operations, responsible for leading the revenue cycle process ... training and performance management. Plays a collaborative role with the director in terms of communication regarding collection activity, compliance, physician… more
- Elara Caring (Rochester Hills, MI)
- …package + Comprehensive onboarding and mentorship + Opportunities for advancement + Medical , dental, and vision benefits, 401K match and paid time off for ... experience In a Health Care setting + Knowledge of Medicare and Medicaid, home health care benefits, policies and...perform job responsibilities You will report to the Branch Director , Alternative Branch Director , or Regional Branch… 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
- Gentiva (Clinton Township, MI)
- …diagnosis, treatment, consultation, and follow-up under the direction of the Palliative Medical Director or Primary Care physician. **As a Nurse Practitioner, ... tests within the scope of professional practice. Order treatments and durable medical equipment as indicated. + Communicate clinical findings to the PSC Physician… 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