- Humana (Lansing, MI)
- …on problems of diverse scope and complexity ranging from moderate to substantial. The Pharmacy Director , internally known as a Clinical Pharmacy Lead, plans, ... Fully Integrated Dual Eligible Special Needs Plan (FIDE-SNP) Michigan Medicare - Medicaid health plan. The individual...management and clinical programming + Represents Humana at all Pharmacy Medicaid meetings including those with the… more
- AmeriHealth Caritas (Detroit, MI)
- …psychosocial needs. This role ensures that care is delivered by Centers for Medicare & Medicaid Services (CMS), state, and organizational guidelines, within the ... individuals with chronic conditions or disabilities. + Strong understanding of Medicare - Medicaid Plan Long-Term Services and Supports (MMP LTSS) programs.… more
- Bayer (Detroit, MI)
- …apply this knowledge to address individual customer concerns; + Broad knowledge of Medicare , managed care, third party payers and Medicaid ; + Demonstrated ... minds to make a real difference, there's only one choice.** **Associate Director , Field Reimbursement, Oncology - Great Lakes Region** **Associate Director ,… more
- Henry Ford Health System (Clinton Township, MI)
- …of preventive service guidelines, clinical practice guidelines, behavior change theory, Medicare and Medicaid regulations and case management principles. . ... Under the direction of VP Operations, CNO, the Regional Director of Case Management is responsible for the development,...a full suite of home health offerings, virtual care, pharmacy , eye care and other health care retail. With… more
- Prime Therapeutics (Lansing, MI)
- …Subject Matter Expertise in their areas of focus (Affordable Care Act, Medicare , Medicaid , Corporate Compliance, Compliance Assessment or Services etc.) + ... legal or compliance related roles for a healthcare or Pharmacy Benefit Management organization, or within a highly regulated...or within a highly regulated industry, including experience with Medicare , Medicaid , and the Affordable Care Act… more
- Prime Therapeutics (Lansing, MI)
- …a healthcare or PBM organization, or other highly regulated industry, including experience with Medicare , Medicaid , and the Affordable Care Act (ACA) + Must be ... and regulatory issues that impact Prime's compliance programs or Board of Pharmacy and Department of Insurance filings; document requirements or disciplinary actions… more
- Prime Therapeutics (Lansing, MI)
- …work experience in a healthcare organization or PBM + Previous experience pricing Commercial, Medicare or Medicaid lines of businesses + 5 years of experience in ... projections + Lead, manage, and review ad hoc complex pharmacy data mining and analyses to help investigate and...**Reporting Structure** + Reports to Senior Principal or Senior Director in the Finance department Potential pay for this… more
- Henry Ford Health System (Troy, MI)
- …for all payor relationships including direct to employer relationships and commercial, Medicare Advantage, Medicaid HMO, and other governmental payors. 4. ... GENERAL SUMMARY: Reporting to the Director - Managed Care Contracting, this position is...a full suite of home health offerings, virtual care, pharmacy , eye care and other health care retail. With… more
- Henry Ford Health System (Troy, MI)
- …forms, and federal and state regulations related to rules/coverage. + Knowledge of Medicare , Medicaid , Blue Cross and other third-party payers billing and ... and deadlines. + Ability to identify when input from Director , Manager or other senior staff members is necessary....a full suite of home health offerings, virtual care, pharmacy , eye care and other health care retail. With… more
- Henry Ford Health System (Detroit, MI)
- …of preventive service guidelines, clinical practice guidelines, behavior change theory, Medicare and Medicaid regulations and case management principles. ... Manager! GENERAL SUMMARY: Under the direction of the department director , the Education Specialist assesses, designs, and evaluates cost-effective,… more