- Molina Healthcare (Sterling Heights, MI)
- …of Program and/or Project management experience. * Managed Care credentialing experience. * Experience working in a cross functional highly matrixed ... sanctions and exclusion monitoring of provider network and integration of credentialing operations for new markets and acquisitions, involving department or… more
- Molina Healthcare (Sterling Heights, MI)
- …services provided to plan members. * Supports plan utilization management program and accompanying action plan(s), which includes strategies to ensure high-quality ... quality of care. * Attends or chairs committees as required such as credentialing , Pharmacy and Therapeutics (P&T) and other committees as directed by the chief… more
- Henry Ford Health System (Troy, MI)
- Reporting to Director or Manager , assist in the development of Contract Strategy and work directly with Payors to lead negotiation of contractual provisions and ... resolution of contracting and operational issues, ie billing, utilization review, credentialing site visits, notification of site closures or new services. 9.… more