- AmeriHealth Caritas (Detroit, MI)
- …care coordination for Medicare beneficiaries with complex medical, behavioral health, Long - Term Services & Supports (LTSS), and psychosocial needs. This ... roles serving individuals with chronic conditions or disabilities. + Strong understanding of Medicare -Medicaid Plan Long - Term Services and Supports (MMP… more
- Henry Ford Health System (Troy, MI)
- …design pharmacy cost management strategies that support affordability, member satisfaction, and long - term sustainability. + Serve as a subject matter expert on ... in 2026 and beyond. Position Summary The Director, Actuarial Services - Pharmacy / Part D is responsible for...Health Alliance Plan (HAP), with a primary focus on Medicare Part D and broader enterprise pharmacy strategy. This… more
- Molina Healthcare (Sterling Heights, MI)
- …the following functions: care management, utilization management, behavioral health, care transitions, long - term services and supports (LTSS), and/or other ... the following areas: utilization management, care management, care transitions, behavioral health, long - term services and supports (LTSS), or equivalent… more
- TEKsystems (Troy, MI)
- …Insurance (Voluntary Life & AD&D for the employee and dependents) * Short and long - term disability * Health Spending Account (HSA) * Transportation benefits * ... day, sometimes more and sometimes less, depending on how long each call lasts. - The calls will be...- Outbound calls are also often necessary. Skills customer service , inbound call, escalation calls, mortgage, contact center, bilingual,… more
- R1 RCM (Detroit, MI)
- …with potential clients **Requirements:** + 10+ years of experience selling services surrounding Medicare reimbursement, combined with a strong/effective presence ... This scale provides unmatched operational insight to help healthcare organizations unlock greater long - term value. To learn more, visit: https://www.r1rcm.com . more
- Humana (Detroit, MI)
- …+ Experience with health promotion, coaching and wellness + Experience with Medicaid Long Term Care + Previous managed care experience + Bilingual- Spanish, ... holidays, volunteer time off, paid parental and caregiver leave), short- term and long - term disability, life...to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel,… more
- Humana (Detroit, MI)
- …+ Experience with health promotion, coaching and wellness + Experience with Medicaid Long Term Care + Previous managed care experience + Bilingual- Spanish, ... holidays, volunteer time off, paid parental and caregiver leave), short- term and long - term disability, life...to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel,… more
- Deloitte (Detroit, MI)
- …including value based care/ACO modeling + Knowledge of group insurance products including disability, long term care, etc. The wage range for this role takes ... December 15th, 2025.Work You'll Do + Provide strategic and technical consulting services to public sector clients + Support engagements focused on Medicaid… more
- United Therapeutics (Detroit, MI)
- …Teams + Advanced knowledge of medical insurance terminology + Knowledge of Centers of Medicare & Medicaid Services (CMS) policies and processes with expertise in ... of essential things like provider engagement, specialty pharmacies, patient services offerings, and the referral process. You want to...In addition, this role is eligible for the Company's short- term and long - term incentive programs.… more
- Molina Healthcare (Sterling Heights, MI)
- …Ownership** + Assists and executes tasks and projects to ensure Centers for Medicare & Medicaid Services (CMS) and State regulatory requirements are met ... health plan leadership and provides well-reasoned recommendations that support short- and long - term business goals. + Partners with Network to communicate… more
- Presbyterian Villages of Michigan (Chesterfield, MI)
- …3 years' experience with Medicare , Medicaid and Third Party billing in Long Term Care. Computer Skills Ability to operate a computer Proficient in ... vendor information, invoices, and payments. **Responsibilities** 1. Compute rates for services rendered to complete billing documents. 2. Review documents to compute… more
- McLaren Health Care (Lake Orion, MI)
- …is known in the community for offering the highest quality of short- term rehabilitation services and personalized long term care. We have a pleasant and ... you regain your independence. We provide superior nursing, therapy and psychological services to help you achieve your goals." The Registered Nurse is responsible… more
- Molina Healthcare (Detroit, MI)
- …Holidays) JOB DESCRIPTION Job Summary Provides support for care management/care coordination long - term services and supports specific activities and ... of MI. This position will support our MMP (Medicaid Medicare Population) will be supporting DSNP. This position will...services for members including behavioral health care and long - term services and supports (LTSS)… more
- Corewell Health (Royal Oak, MI)
- …structure of the GME office. The specialist will interact and establish long - term working relationships with national accrediting organizations, local, national ... + Establishes at the system level, the AAMC's Electronic Residency Application Service (ERAS) software to manage applications and participate in screening of… more
- AbbVie (Detroit, MI)
- …short- term incentive programs. + This job is eligible to participate in our long - term incentive programs Note: No amount of pay is considered to be wages ... areas - immunology, oncology, neuroscience, and eye care - and products and services in our Allergan Aesthetics portfolio. For more information about AbbVie, please… more
- Humana (Sterling Heights, MI)
- …company and personal holidays, volunteer time off, paid parental and caregiver leave), short- term and long - term disability, life insurance and many other ... efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities at large.… more
- Molina Healthcare (Clinton Township, MI)
- …+ Promotes integration of services for members including behavioral health care and long term services and supports, home and community to enhance the ... of MI. This position will support our MMP (Medicaid Medicare Population) that is part of the Community Well...of experience working with persons with disabilities/chronic conditions and Long Term Services & Supports.… more
- Gentiva (Southfield, MI)
- …to MSN) + Free Continuing Education Units (CEUs) + Company-paid Life & Long - Term Disability Insurance + Voluntary Benefits (Pet, Critical Illness, Accident, LTC) ... operations, ensuring compliance with state, federal, and accreditation standards (CMS, Medicare , Joint Commission, etc.) + Provide clinical oversight and ensure… more
- Humana (Detroit, MI)
- …company and personal holidays, volunteer time off, paid parental and caregiver leave), short- term and long - term disability, life insurance and many other ... our customers and our company. Through our Humana insurance services and CenterWell healthcare services , we make...to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel,… more
- Tenet Healthcare (Detroit, MI)
- …Voluntary benefits include pet insurance, legal insurance, accident and critical illness insurance, long term care, elder C childcare, auto C home insurance. ... position integrates national standards for case management scope of services including: Utilization Management supporting medical necessity and denial prevention.… more