- Henry Ford Health System (Troy, MI)
- …skills. + Strong organizational and interpersonal skills. + Strong Understanding of Managed Care Reimbursement methodologies, coding, and terminology. ... EDUCATION/EXPERIENCE REQUIRED: + Bachelor's degree in Finance, Accounting, Business Administration, Managed Care Contracting, Reimbursement , or related… more
- Henry Ford Health System (Troy, MI)
- …Experience in reimbursement and/or data analytics preferred. * Knowledge of managed care organizations and integrated health systems. * Comprehensive project ... GENERAL SUMMARY: Reporting to the Director - Managed Care Contracting, this position is...Care Contracting team in evaluating, analyzing, and negotiating contract terms and reimbursement rates with health… more
- Henry Ford Health System (Detroit, MI)
- …units. PRINCIPAL DUTIES AND RESPONSIBILITIES: 1. Under supervision of Director or Managed Care Contracting, works directly with Payors to negotiate contractual ... years in the healthcare industry in a professional capacity. + Knowledge of managed care organizations and integrated health systems. + Previous contracting,… more
- AmeriHealth Caritas (Detroit, MI)
- … care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral ... managed health care requirements. + 3 to 5 years in a managed care -related or healthcare industry. + Database development techniques and uses for various… more
- Henry Ford Health System (Troy, MI)
- …provider relations or provider reimbursement experience. + Knowledge of managed care organizations and integrated health systems. + Comprehensive project ... to Director or Manager, assist in the development of Contract Strategy and work directly with Payors to lead...Excel. Additional Information + Organization: Corporate Services + Department: Managed Care Contracting + Shift: Day Job… more
- Henry Ford Health System (Detroit, MI)
- …+ Microsoft Excel required. Additional Information + Organization: Corporate Services + Department: Managed Care Contracting + Shift: Day Job + Union Code: Not ... DUTIES AND RESPONSIBILITIES: 1. Responsible for building basic payer/plan-specific contract terms, including common reimbursement methodologies. 2. Achieve… more
- Molina Healthcare (Detroit, MI)
- …or other health care environment. * 3+ years experience in provider contract negotiations in a managed healthcare setting ideally in negotiating different ... that result in high quality, cost effective and marketable providers. Contract /Re-contracting with large scale entities involving custom reimbursement . Executes… more
- Molina Healthcare (Detroit, MI)
- …experience. **Required Experience** 7 - 10 years minimum experience in Healthcare Administration, Managed Care , and/or Provider Network Mgmt & Operations with an ... & Operations, oversees development and implementation of provider network and contract strategies, identifying those specialties and geographic locations upon which… more
- …for resolution. * Analyze data for identification and monitoring of payer trends, managed care / contract compliance, and operational processes specific ... Every day you will research and interpret complex customer/payer contract terms in order to identify and escalate claim...Cycle operations with specific focus on Inpatient and Outpatient Managed Care and Commercial Payers * Proficient… more
- AmeriHealth Caritas (Detroit, MI)
- … care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral ... providers to join the Plan, maintaining financial integrity and contract requirements. + Use plan reports and metrics to...management and recruitment + 5 to 10 years of managed care /health insurance and Medicaid experience. +… more
- R1 RCM (Detroit, MI)
- …will represent healthcare providers in their disputes with medical insurance carriers and managed care organizations at all stages of the administrative appeals ... process. Every day, you will handle contract review and appeal template development based on contractual...you must maintain a foundational understanding of Commercial, Governmental, Managed Care , and ERISA regulations regarding payment,… more
- Black & Veatch (Ann Arbor, MI)
- …sales and contracting process, close the deal and lead the contract signing using a consultative selling approach. **Key Responsibilities** **Solution ... understand client needs and provide relevant solutions. **Sales Process** + Own contract execution process and ensure all sales documentation is completed accurately… more
- Grifols Shared Services North America, Inc (Detroit, MI)
- …connect them with the customer as appropriate + Possess an understanding of the Managed Care landscape and when to utilize necessary internal resources to assist ... and functions including Territory Sales Representatives, Regional Sales Directors, Managed Markets, the Product Brand Team and other necessary stakeholders.… more
- Molina Healthcare (Detroit, MI)
- …Knowledge and experience with value-based contracting. * In-depth knowledge of managed care business, regulatory/legal requirements, products, programs, strategy ... relationships and communications. Manages a team of employees who develop, negotiate, contract and enhance provider networks that are high quality, cost efficient… more
- Trinity Health (Livonia, MI)
- …operational initiatives including new services/programs, revenue enhancement, expense reduction, managed care utilization systems, and strategies. Responsible ... the dissemination of all pharmaceutical product information to patients and health care professionals. Ensures appropriate inventory and contract compliance. +… more
- Black & Veatch (Ann Arbor, MI)
- …lead from start to finish including opportunity development and contract negotiation; client mgmt) + Strategic development/implementation **Minimum Qualifications** ... Bachelor's degree or relevant work experience + Has successfully managed multiple engagements simultaneously + Contributor or leader to...of this commitment and offers an array of health care benefits including but not limited to medical, dental… more
- Black & Veatch (Ann Arbor, MI)
- …Qualifications** + Bachelor's Degree or relevant work experience. + Has managed significant engagements. + 10+ years in a business/consulting environment. All ... lead from start to finish including opportunity development and contract negotiation; client mgmt) + Proven track record of...of this commitment and offers an array of health care benefits including but not limited to medical, dental… more
- Black & Veatch (Ann Arbor, MI)
- …lead from start to finish including opportunity development and contract negotiation; client mgmt) + Strategic development/implementation **Minimum Qualifications** ... Bachelor's degree or relevant work experience + Has successfully managed multiple engagements simultaneously + Contributor or leader to...of this commitment and offers an array of health care benefits including but not limited to medical, dental… more
- Black & Veatch (Ann Arbor, MI)
- …transition proposal basis information to the project execution team upon contract signature. + Establish solution execution platforms (processes, tools, templates) + ... 15+ years in a business/consulting environment + Has successfully managed multiple engagements simultaneously + Contributor or leader to...of this commitment and offers an array of health care benefits including but not limited to medical, dental… more