- CVS Health (Lansing, MI)
- …seeking an experienced Senior Healthcare Fraud Investigator to join our Dental/ Pharmacy /Broker Investigative Team within Aetna's Special Investigations Unit. In this ... and legal review. + Documents all appropriate case activity in case tracking system . + Prepare written case summaries and make referrals to State and Federal… more
- Molina Healthcare (Sterling Heights, MI)
- …providers and medical managers regarding utilization practices, guideline usage, pharmacy utilization and effective resource management. + Develops and implements ... QUALIFICATIONS** **REQUIRED EDUCATION:** + Doctorate Degree in Medicine + Board Certified or eligible in a primary care specialty **REQUIRED EXPERIENCE/KNOWLEDGE,… more
- Sedgwick (Lansing, MI)
- …achieve. Newsweek Recognizes Sedgwick as America's Greatest Workplaces National Top Companies Certified as a Great Place to Work(R) Fortune Best Workplaces in ... + Knowledge of utilization review procedures + Knowledge of clinical quality systems and measurements + Knowledge of resources available regarding regulations and… more
- Corewell Health (Grand Rapids, MI)
- …patients with RN, MA, MSW, dedicated specialty nurse navigators, pharmacists, and pharmacy technician support + High volumes and the busiest cardiovascular facility ... workweek Requirements: + Medical degree (MD or DO) + Board- certified in Cardiovascular Disease from an accredited institution +...to the health of our organization. As a health system , we advocate for equity as we care for… more
- Corewell Health (Grand Rapids, MI)
- …care plans with various consulting physician services, nursing, respiratory therapy, pharmacy , nutritional support, and other ancillary teams. In addition to these ... experience + LIC-Physician Assistant - State of Michigan + CRT-Physician Asst Certified (PA-C) - NCCPA National Commission on Certification of Physician Assistants +… more
- Pine Rest Christian Mental Health Services (Portage, MI)
- …disorders. We are much more than just the third largest non-profit behavioral health system in the country, our 220-acre main campus, and our network of clinical ... entry and maintaining medical records in Pine Reset Electronic Medical Record system , including assisting physicians in completing medical records. + In clinical… more
- Molina Healthcare (Detroit, MI)
- …use of information from multiple sources, including claims/encounters, pharmacy , utilization management, clinical indicators, industry benchmark, and/or ... Visio (flow chart equivalent) and demonstrated ability to learn new information systems and software programs. **PREFERRED EDUCATION:** Master's Degree or higher in… more
- University of Michigan (Ann Arbor, MI)
- …and clinical care. Close interactions with the Schools of Engineering and Pharmacy and with the biotech and pharmaceutical industries facilitate the development of ... innovative technologies, drugs and drug delivery systems , and enable expeditious early-phase testing of new potential cancer treatments. **Required Qualifications… more