• CRT Claims Examiner

    Integra Partners (Troy, MI)
    …for development Knowledge/Skills/Abilities + 5+ years of experience in medical claims processing, billing, or revenue cycle management . + Knowledge of DME ... payer-specific guidelines. + Document claim activity and payer communications in the claims management system. + Assist providers and patients with claim-related… more
    Integra Partners (05/06/25)
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  • Claims Consultant | Risk Finance…

    Henry Ford Health System (Detroit, MI)
    …in professional and general liability, workers compensation and employers liability claims review, investigation, management and disposition, including financial ... mitigation of indemnity payment and claim defense costs and management of System reputation Will work under the guidance...System reputation Will work under the guidance of Senior Claims Managers, Senior Claims Consultant, Director more
    Henry Ford Health System (05/21/25)
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  • Medical Director - Medicaid N.…

    Humana (Lansing, MI)
    …community and help us put health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work ... Lead Medical Director - North Central Medicaid Markets. The Medical Director conducts Utilization Management of the care received by members in the… more
    Humana (05/14/25)
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  • Medical Director , Global…

    Otsuka America Pharmaceutical Inc. (Lansing, MI)
    …medicines for those with CNS disorders, we are seeking a skilled and experienced Medical Director of CNS Early Assets, Global Medical Affairs, responsible ... , Franchise Lead CNS Early Assets. **Position Summary:** The Medical Director , Global Medical Affairs,...for any assigned assets in development. + Support lifecycle management initiatives and planning for assigned assets as applicable.… more
    Otsuka America Pharmaceutical Inc. (04/17/25)
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  • Medical Director - Pacific SW Region

    Humana (Lansing, MI)
    …community and help us put health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work ... Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an… more
    Humana (05/10/25)
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  • Medical Director - Care Plus…

    Humana (Lansing, MI)
    …community and help us put health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work ... Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an… more
    Humana (04/24/25)
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  • Medical Director - Florida

    Humana (Lansing, MI)
    …community and help us put health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work ... Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an… more
    Humana (05/22/25)
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  • Director , Field Reimbursement…

    Otsuka America Pharmaceutical Inc. (Lansing, MI)
    Director of Field Reimbursement Management (FRM) Position Overview We are seeking an experienced, transformative leader to serve as the Director of Field ... within the assigned region Key Competencies + Strategic leadership and team management + Patient-centric approach to healthcare delivery + Operational excellence and… more
    Otsuka America Pharmaceutical Inc. (05/23/25)
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  • Director , Global Medical

    Otsuka America Pharmaceutical Inc. (Lansing, MI)
    The Director , Global Medical Publications will support Otsuka in leading and developing an overall scientific communication strategy for publications and ... congresses, and will work closely with the Global Medical Affairs Teams, Clinical Teams, Global Value & Real-World Evidence Teams, and Publications Management more
    Otsuka America Pharmaceutical Inc. (04/17/25)
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  • Medical Director Specialty…

    Molina Healthcare (Warren, MI)
    **JOB DESCRIPTION** **Job Summary** The Medical Director for Specialty Medical Services & Market Performance will provide clinical expertise and support to ... activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. +...claims and appeals and resolves grievances related to medical quality of care. + Attends or chairs committees… more
    Molina Healthcare (04/09/25)
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  • Corporate Medical Director

    Humana (Lansing, MI)
    …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 problems of diverse scope and complexity...focused on continuously improving consumer experiences **Preferred Qualifications** + Medical utilization management experience + Working with… more
    Humana (04/24/25)
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  • Director , Global Clinical Development

    Otsuka America Pharmaceutical Inc. (Lansing, MI)
    …personnel management experience, will support position at entry (Associate Director / Director ). + An advanced understanding of drug development principles and ... disciplines, including immunology, biostatistics, clinical pharmacology, formulation science, data management , and medical writing. + Experience with the… more
    Otsuka America Pharmaceutical Inc. (04/17/25)
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  • Director , Global Clinical…

    Otsuka America Pharmaceutical Inc. (Lansing, MI)
    …personnel management experience, will support position at entry (Associate Director / Director ). + An advanced understanding of drug development principles and ... disciplines, including immunology, biostatistics, clinical pharmacology, formulation science, data management , and medical writing. + Complete understanding of… more
    Otsuka America Pharmaceutical Inc. (04/17/25)
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  • Medical Director (Medicare)

    Molina Healthcare (Grand Rapids, MI)
    …quality improvement activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to ... claims and appeals and resolves grievances related to medical quality of care. + Attends or chairs committees...experience, including: + 2 years previous experience as a Medical Director in a clinical practice. +… more
    Molina Healthcare (05/02/25)
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  • Risk Management Director

    Dart Container (Mason, MI)
    Risk Management Director Apply now " Date: May 7, 2025 Location: Mason, MI, US Company: Dart Container We have an opening for a Risk Management Director ... programs, commercial lines of property, casualty and workers' compensation programs, and claims management to include setting and executing strategy +… more
    Dart Container (05/03/25)
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  • Medical Director - Medicare…

    Humana (Lansing, MI)
    …us put health first** The Corporate Medical Director relies on medical background and reviews health claims and preservice appeals. The Corporate ... Medical Director works on problems of diverse scope and complexity...focused on continuously improving consumer experiences **Preferred Qualifications** + Medical utilization management experience, + working with… more
    Humana (05/14/25)
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  • Sr Director , Performance Suite Analytics

    Evolent (Lansing, MI)
    …health outcomes and a more connected care journey. We are hiring for a Senior Director to join our Finance Team. The candidate selected for this role will be part ... and its customers in the Performance Suite where Evolent does not pay claims + Establish ideal data transfer protocols during client onboarding and implementation,… more
    Evolent (05/02/25)
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  • Director , Specialty Pharmacy Operations

    Otsuka America Pharmaceutical Inc. (Lansing, MI)
    …Specialty Pharmacy operations for OAPI The position will report to the Executive Director , Channel Strategy and Patient Affordability We are seeking a highly skilled ... and motivated Director of Specialty Pharmacy Operations to lead and oversee...with cross-functional teams, including Brand Marketing, Sales, Patient Access, Medical Affairs, and Regulatory, to integrate pharmacy operations seamlessly… more
    Otsuka America Pharmaceutical Inc. (05/23/25)
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  • Senior Director , Global Clinical…

    Otsuka America Pharmaceutical Inc. (Lansing, MI)
    …medicine and/or clinical pharmacology and associated disciplines (eg biostatistics, data management , medical writing). + An advanced understanding of clinical ... in support of domestic and international clinical development initiatives. The Senior Director , GCD works in a multidisciplinary matrix environment and supports the… more
    Otsuka America Pharmaceutical Inc. (04/17/25)
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  • Associate Director , Established Brands…

    Otsuka America Pharmaceutical Inc. (Lansing, MI)
    **_Associate Director , Established Brands Marketing_** **Position Summary** The Associate Director , Established Brands Marketing is responsible for driving ... CNS portfolio. The individual will work closely with market access, sales, medical affairs, and finance to implement commercial strategies that sustain product… more
    Otsuka America Pharmaceutical Inc. (05/16/25)
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