- 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
- Molina Healthcare (Sterling Heights, MI)
- …with Medicaid contract analytics is highly preferred. + Experience working on Managed care analytics and healthcare reimbursement models is required. + ... materials and documentation archives. + Demonstrate Healthcare experience in contract modeling, analyzing relevant Financial and Utilization Metrics of Healthcare.… more
- Molina Healthcare (Sterling Heights, MI)
- …in health care field including, but not limited to, provider's office, managed care , or other health care field. **REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS ... to meet Molina's network adequacy standards. * Clearly and professionally communicates contract terms, payment structures, and reimbursement rates to physician,… more
- Molina Healthcare (Sterling Heights, 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
- AmeriHealth Caritas (Southfield, MI)
- …+ Master's Degree preferred. + 10 or more years of experience years of managed care provider contracting and reimbursement experience, including in-depth ... care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral… more
- R1 RCM (Detroit, MI)
- …and counsel 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
- 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
- AmeriHealth Caritas (Detroit, MI)
- …working with healthcare providers and provider relations + 3 years of experience in managed care or health insurance preferred. + Proficiency in Microsoft Excel ... + Escalate discrepancies or requests that conflict with business processes or contract terms. + Ensure timely and accurate management of provider contracts,… more