- Highmark Health (Lansing, MI)
- …including the growing number of laws and regulations governing managed care organizations. The Manager , Medicaid Compliance & Operations acts as a trusted ... contracts. The position actively manages the day-to-day operations of the Medicaid Compliance Program, and contributes to the operational workflow for … more
- Humana (Lansing, MI)
- …development; and + Creating and executing comprehensive test plans + Ongoing Medicaid pricer maintenance, quality assurance, and compliance + Determining root ... a part of our caring community and help us put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business Intelligence… more
- CVS Health (Lansing, MI)
- …and communication skills to support, manage and develop and execute Medicare and Medicaid compliance programs and processes that promote compliant and ethical ... current focus on integrated special needs plans. The Sr. Manager Compliance maintains productive relationships and open...exhibit the following: - -Extensive knowledge of Medicare and Medicaid compliance programs and rules, including rules… more
- Prime Therapeutics (Lansing, MI)
- …Posting Title** Manager , Compliance - Remote **Job Description** The Compliance Manager works closely with designated business areas, Legal, and other ... Expertise in their areas of focus (Affordable Care Act, Medicare, Medicaid , Corporate Compliance , Compliance Assessment or Services etc.) + Develop and… more
- Prime Therapeutics (Lansing, MI)
- … with federal laws, state laws and standards of practice which govern the Medicaid Drug Rebate Program. + Ensures compliance with each State Medicaid ... passion and drives every decision we make. **Job Posting Title** Manager Rebate Pharmacy Operations **Job Description Summary** This position provides administrative… more
- Humana (Lansing, MI)
- …health outcomes for our dual members - members that qualify for both Medicare and Medicaid . The Lead Product Manager sits in the center of strategy, design, ... first** We are looking for a dynamic Lead Product Manager to develop clinical solutions for our members and...a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at… more
- Munson Healthcare (Traverse City, MI)
- …and administrative functions of our multisite Home Care offices. You'll ensure regulatory compliance (Medicare, Medicaid , CHAP), manage budgets, set and meet key ... Home Care Manager - On-Site | Munson Home Health Find...participating in on-call rotation, and leading quality improvement and compliance activities. What's Required + Education & Licensure: +… more
- Prime Therapeutics (Lansing, MI)
- …our passion and drives every decision we make. **Job Posting Title** Client Quality Manager Stars and Quality - Remote **Job Description** The Senior Client Quality ... Manager ensures the successful planning, implementation and execution of...provides leadership and subject matter expertise on Medicare Stars, Medicaid quality and the Commercial/Health Insurance Marketplace Quality Rating… more
- Gentiva (Grand Rapids, MI)
- …difference in people's lives every day. **Overview** We're looking for a **Patient Care Manager Senior** to join our team. You will report directly to the Executive ... developing associates and ensuring adherence to company policies and procedures and compliance with local, state, and federal regulations and regulatory agencies. +… more
- Molina Healthcare (Detroit, MI)
- …contractual requirements related to government programs including, but not limited to, Medicaid , duals (MMP) and Marketplace. * Serves as primary internal contact ... interpretations. * Monitors daily Government Contracts activities to ensure contractual compliance with state and federal requirements for all lines of business… more
- Prime Therapeutics (Lansing, MI)
- …and ability to adjust focus **Reporting Structure** + Reports to Sr Professional, Manager , Director or Senior Director in the Compliance department Potential pay ... our passion and drives every decision we make. **Job Posting Title** Senior Compliance Analyst (Interpretation and Advising) - Remote **Job Description** The Senior … more
- Corewell Health (Royal Oak, MI)
- …receive the appropriate training and education needed to provide quality outcomes and compliance with OME governing regulations. The GME Manager ensures OME team ... assigned departments, residency programs, and the organization as a whole. The GME Manager ensures OME team members positively affects the overall morale of the OME… more
- Henry Ford Health System (Detroit, MI)
- …Register today by following this link: qrco.de/bffvep Job Summary: The Case Manager -RN plays a pivotal role in coordinating comprehensive patient care, ensuring ... skills, and a deep understanding of healthcare systems. The Case Manager -RN will collaborate closely with patients, families, healthcare providers, and community… more
- Gentiva (Portage, MI)
- …in people's lives every day. **Overview** We're looking for a **Patient Care Manager ** to join our team.You will report directly to the Executive Director, ... Administrator, or Senior Patient Care Manager . You will be responsible for maintaining a high...and ensuring adherence to company policies and procedures and compliance with local, state, and federal regulations and regulatory… more
- Prime Therapeutics (Lansing, MI)
- …management in the areas of problem identification and resolution, process improvements, compliance with Centers for Medicare & Medicaid Services (CMS) ... passion and drives every decision we make. **Job Posting Title** Vendor Program Manager Senior **Job Description** The Vendor Program Manager is responsible for… more
- McLaren Health Care (Lansing, MI)
- …and community service needs within 24 hours of admission. 2. Receives RN Care Manager referrals to social work based on identified Social Work Triggers (see SW ... preferences, needs and strengths, to foster for the interdisciplinary team in compliance with standards of care. 9. Interviews patient and significant others to… more
- Datavant (Lansing, MI)
- …to realize our bold vision for healthcare. **Role Overview** As a Product Manager , Risk Adjustment Analytics Products, you will contribute to the strategy and ... and support value-based client delivery across Medicare Advantage, ACA, and Medicaid programs. The ideal candidate combines deep healthcare analytics expertise with… more
- Molina Healthcare (Ann Arbor, MI)
- …Molina Healthcare's overall mission, core values, and strategic plan and in compliance with all relevant federal, state and local regulations. Negotiates and ... knit proximity ongoing after contract. * In conjunction with Director/ Manager , Provider Contracts, negotiates and analyzes, Complex Provider contracts including… more
- Lundbeck (Lansing, MI)
- …anticipate and effectively address payer access issues (IDNs, Medicare, Medicaid , Commercial) using Lundbeck resources. **Pharmaceutical Environment/ Compliance ** ... Multi-Specialty Account Manager - Lansing, MI Requisition ID: 6461 Location:...the primary care and neurology settings. As an Account Manager , you lead the promotion of our psychiatry portfolio,… more
- Prime Healthcare (Port Huron, MI)
- …Safety Excellence Award, rated four stars by the Centers for Medicare & Medicaid Services and earned The Joint Commission's Gold Seal of Approval(R) for Hospital ... Accreditation by demonstrating continuous compliance with its performance standards. Learn more atwww.mylakehuron.com. As...Work for Licensed Clinical Social Worker. However, RN Case Manager preferred. + Five years acute care nursing experience… more