- Molina Healthcare (Ann Arbor, MI)
- …and distribute standard reports on schedule + Position reports to AVP, Payment Integrity Analytics **JOB QUALIFICATIONS** **REQUIRED EDUCATION** : + Bachelor's ... and/or Project management experience. + Managed Care experience - **_specifically within Payment Integrity , Claims Payment , Provider Relations Experience_**… more
- Molina Healthcare (Ann Arbor, MI)
- …work of external vendors. Assigns, directs and monitors system analysis and program staff. These positions' primary focus is project/ program management. **Job ... of external vendors. + Focuses on process improvement, organizational change management, program management and other processes relative to the business. + Leads and… more
- Molina Healthcare (Ann Arbor, MI)
- …This role focuses on identifying and executing operational initiatives tied to Payment Integrity (PI) and provider claims accuracy. The individual will ... lens to ensure accurate interpretation of provider claims trends, payment integrity issues, and process gaps. +...6 years of experience as a Business Analyst or Program Manager in a Managed Care Organization… more
- Molina Healthcare (Ann Arbor, MI)
- …workflows and controls across intake, adjudication, adjustments, appeals/grievances, and payment integrity . + Technology Enablement: Oversee requirements, ... (Healthcare/Claims)** + Deep understanding of claims lifecycle, EDI transactions, payment integrity , provider data, appeals/grievances, and audit/compliance… more
- BASF (Wyandotte, MI)
- **Now hiring! Maintenance Manager ** We are looking for a Maintenance Manager to join our Dispersions & Resins (ED) team in Wyandotte, Michigan. (Onsite) **Come ... create chemistry with us!** We are seeking a Maintenance Manager who will be responsible for direct management of...of presence in Maintenance activities; sets the example for integrity and priorities; utilizes Mindset & Behaviors tools and… more
- Signet Jewelers (Dearborn, MI)
- …rewarding opportunities to impact the lives of others and inspire love. Join us! STORE MANAGER Title: Store Manager Reports To: District Manager Reporting to ... and Inventory Control Position Summary: Reporting to the District Manager (DM), the Store Manager (SM) will...of professionalism to customers and team members by displaying integrity and honesty at all times, and by conducting… more
- Molina Healthcare (Ann Arbor, MI)
- …level of care, inpatient readmission, and any opportunity identified by the payment Integrity analytical team; makes decisions and recommendations pertinent to ... for medical claim review activities. Responsible for ensuring timely claims payment processes, providing counsel to members regarding coverage and benefit… more
- Molina Healthcare (Ann Arbor, MI)
- …Level of Care, Inpatient Readmission, and any opportunity identified by the Payment Integrity analytical team; requires decision making pertinent to clinical ... database + Provides supporting documentation for denial and modification of payment decisions + Independently re-evaluates medical claims and associated records by… more
- TD Bank (Southfield, MI)
- …to simplify, problem solve, multitask and work effectively against deadlines + Integrity and high moral standards + Strong negotiation and conflict resolution skills ... service agreements, procurement contracts or RFPs + Experience with business payment networks (eg, ACH/Nacha rules, wires), cash management, deposits or other… more