- Molina Healthcare (Detroit, MI)
- JOB DESCRIPTION Job Summary Provides medical oversight and expertise in appropriateness and medical necessity of services provided to members, targeting ... and cost-effective member care. Essential Job Duties * Determines appropriateness and medical necessity of health care services provided to plan members. * Supports… more
- Gentiva (Monroe, MI)
- …Hospice and Palliative Medicine board certification and/or Hospice Medical Director Certification Board certification preferred. + Current Medicare Provider ... Transform Care through Compassionate Hospice Leadership.** We are seeking a dedicated Hospice Medical Director to join our leadership team and provide expert… more
- Humana (Detroit, MI)
- …of everything it does. The MarketPoint Career Channel Team is looking for skilled Medicare Field Sales Agents. This is a field-based role, and candidates must live ... community. As part of a collaborative team of 8-12 Medicare Sales Agents, you'll work under the guidance of...under the guidance of a Senior Manager and Regional Director who are committed to your success. Together, you'll… more
- Molina Healthcare (Detroit, MI)
- …to standardize policies and procedures. + Recruits, hires, trains, mentors, and develops medical director staff and team members as needed. + Ensures ... behavioral health and at least 3 years as a medical director in a managed care setting...management policies across health plans or navigating varied state Medicaid/ Medicare regulations. + Working knowledge of national, state, and… more
- R1 RCM (Detroit, MI)
- …transform the patient experience and financial performance of hospitals, health systems and medical groups. We are the one company that combines the deep expertise ... enhancing the patient experience. As the Government Navigation Services (GNS) Business Development Director , you will focus on engaging and targeting new Tier 1 and… more
- Molina Healthcare (Detroit, MI)
- …reviews behavioral health portions of state contracts. * Assists behavioral health medical director lead trainers in the development of enterprise-wide education ... JOB DESCRIPTION Job SummaryProvides medical oversight and expertise related to behavioral health...National Committee for Quality Assurance (NCQA) and Centers for Medicare and Medicaid Services (CMS). * Assists with the… more
- Bausch + Lomb (Detroit, MI)
- …**Overview** Through depth and breadth of customer and industry knowledge, the ** Director , National Accounts** will be responsible for aiding in the development of ... these programs it is also the expectation that the National Account Director will take responsibility for communication, facilitation and implementation with these… more
- Tenet Healthcare (Detroit, MI)
- Director - Case Management - 2506004210 Description : Are you a results-driven leader ready to make a meaningful impact to patients, caregivers, and your community? ... development, and work-life balance. The available plans and programs include: * Medical , dental, vision, and life insurance * 401(k) retirement savings plan with… more
- Henry Ford Health System (Detroit, MI)
- …and system medical education office(s) and alumni. * Assists program director in development of program and departmental goals and objectives. * Assists the ... GENERAL SUMMARY: Reporting to the Medical Education Manager, the Graduate Medical ...residents in conjunction with the chief resident and/or Program Director to complement hospital and system orientation. * Ensures… more
- Guidehouse (Detroit, MI)
- …remote **What You Will Do** **:** + Under the direction of the Director of Revenue Integrity, the Revenue Integrity Coding Billing Specialistprovides revenue cycle ... services through efficient review and timely resolution of assigned Medicare and third party payer accounts that are subject...Coding Initiatives (CCI) + Medically Unlikely Edits (MUE) + Medical Necessity edits + Other claim level edits as… more
- Danaher Corporation (Detroit, MI)
- …engagement and responding to customer inquiries. This position reports to the Senior Director Market Access Americas and is part of the Value and Access team. ... + Communicate regional and local coverage and reimbursement issues for Medicare , Medicaid and Commercial payers through internal meetings, payer research, and… more
- Gentiva (Southfield, MI)
- …medical needs. You will work autonomously in collaboration with the Palliative Medical Director , delivering exceptional care and guiding patients and families ... every stage of treatment. **Responsibilities:** + Collaborate with the Palliative Medical Director and care team to deliver comprehensive, patient-centered… more
- Molina Healthcare (Detroit, MI)
- …and champion networks, as applicable. **Job Duties** + Works closely with the Chief Medical Officer and Director of Population Health to develop and execute the ... priorities. + Demonstrates thorough understanding of Molina's product lines, Medicaid, Medicare SNP, Marketplace, MMP, etc. + Develops strategy to evaluate the… more