- Integra Partners (Troy, MI)
- The Project Manager - Healthcare Claims Management (Subject Matter Expert) is responsible for leading complex projects and initiatives related to ... improvements. This role requires deep subject matter expertise in healthcare claims systems, workflows, and regulatory requirements.... management, with at least 3 years in a project management capacity. + Deep knowledge of claims… more
- Molina Healthcare (Sterling Heights, MI)
- …although they may have technical team members. **Expanded Scope:** The Senior Project Manager for Claims Operations drives complex, multi-workstream ... PMO standards, stage gates, and financial controls. + **Operational & Regulatory Acumen ( Healthcare / Claims )** + Deep understanding of claims lifecycle, EDI… more
- Molina Healthcare (Sterling Heights, MI)
- …keeping, performance coaching, development, and career paths. + Daily management of Healthcare Analytics team. + Allocate new report/ project requests (workload ... their projects, maintains internal work plans as well as project work plans to meet reporting needs of the...leadership experience + 10 years' work experience preferable in claims processing environment and/or healthcare environment +… more
- Molina Healthcare (Sterling Heights, MI)
- …and/or Project management experience. + Operational Process Improvement experience. + Healthcare experience. + Experience with Microsoft Project and Visio. + ... matter experts, delivering products through the design process to completion including project rollout and communication plans. May engage and oversee the work of… more
- Molina Healthcare (Sterling Heights, MI)
- …trends, payment integrity issues, and process gaps. + Applies understanding of healthcare regulations, managed care claims workflows, and provider reimbursement ... operational initiatives tied to Payment Integrity (PI) and provider claims accuracy. The individual will be relied upon to...years of experience as a Business Analyst or Program Manager in a Managed Care Organization (MCO) or health… more
- Molina Healthcare (Sterling Heights, MI)
- …Responsible for accurate and timely auditing of critical information on claims databases. Maintains critical auditing and outcome information. Synchronizes data ... among operational and claims systems and application of business rules as they...complex MRDT and other configuration update scripts * Assists manager in establishing standards, guidelines, and best practices for… more
- Molina Healthcare (Sterling Heights, MI)
- …recommendations for improvement to decision-makers. At the direction of the Manager , Encounters, collaborates with cross-functional teams to identify and resolve ... rejection inventory, and works with other areas including IT, health plan, claims , provider, enrollment, regulators, and external vendors, as needed, to remediate… more
- Trinity Health (Pontiac, MI)
- …**Shift:** Rotating Shift **Description:** **POSITION PURPOSE** Functions as the General Manager responsible for the oversight and coordination of the day-to-day ... in a large or sizeable multi-hospital setting. The Senior Manager of Food & Nutrition Services is responsible for...adapt to change. Demonstrates the ability to develop a project plan for major projects with milestones to determine… more
- GE Aerospace (Detroit, MI)
- …that affects the lives of millions around the world! As a Contract Performance Manager , you will have a major impact on GE profitability through owning overall ... terms & conditions (T&Cs) of the contract, and the management of claims . The role requires cross-functional leadership capability and has autonomy within your… more