- Humana (Lansing, MI)
- …of our caring community and help us put health first** Humana is seeking a Manager , Quality Assurance (External LTSS Oversight Team Manager ) who will lead a team ... The Manger, Quality Assurance collaborates with external partners such as Area Agencies on Aging (AAA) and assist with monitoring day-to-day operational… more
- Molina Healthcare (Grand Rapids, MI)
- …programs. + Serves as the subject matter expert of capabilities in the functional area and leads programs to meet critical needs. + Manages the vetting of potential ... + 5-7 years of product development experience. + Managed Care (specifically Medicaid ) experience. + Experience working in a cross functional highly matrixed… more
- Humana (Detroit, MI)
- … area in Wayne or Macomb county, to conduct in home visits with Medicare/ Medicaid members.** The Field Care Manager Nurse 2 employs a variety of strategies, ... and help us put health first** The Field Care Manager Nurse 2 assesses and evaluates member's needs and...with health promotion, coaching and wellness + Experience with Medicaid Long Term Care + Previous managed care experience… more
- Humana (Lansing, MI)
- …licensed, highly motivated and self-driven individuals to join our team. Our Senior Manager , Medicare Sales, motivates and drives a team of Medicare Sales Field ... the field in the Nashville,** **Chattanooga, and Knoxville** **TN area working with your team and meeting members face...and train a team of sales individuals. The Senior Manager , Medicare Sales, must have a solid understanding of… more
- Humana (Lansing, MI)
- …community and help us put health first** The Special Investigations Unit Manager leads and monitors investigations of allegations of fraudulent and abusive ... practices. The Manager , Fraud and Waste works within specific guidelines and...tactical operations for projects and initiatives involving own departmental area . Requires cross departmental collaboration, and conducts briefings and… more
- Cardinal Health (Lansing, MI)
- …long and short-range changes in the reimbursement environment including Medicare, Medicaid , Managed Care, and Commercial medical and pharmacy plans while planning ... preferred + Knowledge of Medicare (A, B, C, D), Medicaid & Commercial payers policies and guidelines for coverage,...of assignments + In-depth knowledge in technical or specialty area + Applies advanced skills to resolve complex problems… more
- Humana (Lansing, MI)
- …of our caring community and help us put health first** The Manager , Utilization Management Nursing (LTSS Utilization Management Leader) utilizes clinical nursing ... communication of medical services and/or benefit administration determinations. The Manager , Utilization Management Nursing works within specific guidelines and… more
- CVS Health (Lansing, MI)
- …compassionate. And we do it all with heart, each and every day. **Case Manager RN** WFH Flexible **Position Summary** **This position offers a $5,000 New Hire ... on our members who are enrolled in Medicare and Medicaid and present with a wide range of complex...teams virtually -Ability to travel within a designated geographic area for in-person case management activities as directed by… more
- State of Michigan (MI)
- Physician Manager 20 - Medical Director Print (https://www.governmentjobs.com/careers/michigan/jobs/newprint/4848644) Apply Physician Manager 20 - Medical ... may require possession of board certification in a specialty area . Some positions may require a Controlled Substance license....select your level of experience in following Centers for Medicaid and Medicare Services (CMS) for long-term care. +… more
- Henry Ford Health System (Detroit, MI)
- …Management in a large acute care hospital setting. GENERAL SUMMARY: The Case Manager SW provides therapeutic intervention and social work services to patients and ... functions required. Knowledge of child and adult protection laws, state Medicaid guidelines, NASW code of ethics (professional standards), and confidentiality and… more