- Humana (Lansing, MI)
- **Become a part of 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. The Corporate Medical Director works on...experience + Knowledge of the managed care industry including Medicare , Medicaid and/or Commercial products + Must be passionate… more
- Humana (Lansing, MI)
- **Become a part of our caring community and help us put health first** The Corporate Medical Director relies on medical background and reviews health ... claims. The Corporate Medical Director works on problems of diverse...experience + Knowledge of the managed care industry including Medicare , Medicaid and or Commercial products + Possess analysis… more
- CVS Health (Lansing, MI)
- …is hiring a local Broker Manager to support the growth of our industry leading Medicare business. This is a highly collaborative role that will report to the Sales ... leads, and overall, in-person sales activity - Local sales director will provide guidance on expectations for field visits...5 years sales and/or Broker sales experience in the Medicare industry. - Must be located in Southeastern Michigan… more
- Humana (Lansing, MI)
- …Information** Typically reports to a Regional Vice President of Health Services, Lead, or Corporate Medical Director , depending on size of region or line ... caring community and help us put health first** The Medical Director relies on medical ...materials, internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and … more
- Humana (Lansing, MI)
- …Information** Typically reports to a Regional Vice President of Health Services, Lead, or Corporate Medical Director , depending on size of region or line ... caring community and help us put health first** The Medical Director relies on medical ...materials, internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and … more
- Humana (Lansing, MI)
- …Information** Typically reports to a Regional Vice President of Health Services, Lead, or Corporate Medical Director , depending on size of region or line ... caring community and help us put health first** The Medical Director relies on medical ...group practice management. + Utilization management experience in a medical management review organization, such as Medicare … more
- Humana (Lansing, MI)
- …diverse scope and complexity ranging from moderate to substantial. The Associate Director , Data Quality/Integrity will lead and manage the HEDIS Supplemental Data ... metrics, documentation, quality controls, reporting, and exceptional delivery. The Associate Director will be responsible for ensuring the team lives Humana's… more
- Evolent (Lansing, MI)
- …**What You'll Be Doing:** Seeking a detail-oriented **Clinical Rules Management, Associate Director ** who will play a critical role in ensuring the accuracy and ... Lead the evaluation of clinical processes in collaboration with other clinical corporate , division, and facility teams to facilitate process redesign and guide… more
- Gentiva (Flint, MI)
- …Provides diagnosis, treatment, consultation, and follow-up under the direction of the Palliative Medical Director (if required under State law). **As a Nurse ... Practitioner, you will:** + Work in collaboration with the Palliative Care Medical Director and other palliative team members to deliver palliative care by… 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
- Molina Healthcare (Sterling Heights, 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
- Humana (Lansing, MI)
- …The IT Infrastructure Procurement Category Manager will report directly into the Director of IT Infrastructure Procurement and will lead the development of category ... of commercial protection and to minimize risk to Humana. + Drive corporate compliance to the preferred-supplier program via end-user change management and… 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
- LifePoint Health (Ishpeming, MI)
- …insure rigorous infection control standards that meet JCAHO, OHSA, Centers for Medicaid/ Medicare Services, Centers for Disease Control and Prevention (CDC), APIC and ... identified needs to promote quality and patient safety. Works closely with Quality director in developing and maintaining the quality program and the education of… more