• Case Manager, Registered Nurse - Fully…

    CVS Health (Lansing, MI)
    …do it all with heart, each and every day. **Position Summary** **This is a remote work from home role anywhere in the US with virtual training.** American Health ... Management. AHH delivers flexible medical management services that support cost-effective quality care for members. **Key Responsibilities** + This position consists… more
    CVS Health (11/27/25)
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  • CDQI Nurse Specialist - Part Time - Remote

    Datavant (Lansing, MI)
    …to realize our bold vision for healthcare. **What We're Looking For:** As a Clinical Documentation Quality Improvement (CDQI) Specialist, you will play a pivotal ... to enhance documentation clarity, completeness, and overall medical record quality . By ensuring accurate and comprehensive physician documentation, you will… more
    Datavant (11/11/25)
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  • Transplant Care Nurse ( Remote )

    Highmark Health (Lansing, MI)
    …over a specified panel of members that range in health status/severity and clinical needs; and assesses health management needs of the assigned member panel and ... utilizing data/analytics in conjunction with professional clinical judgement to identify the right clinical ...personal health goals. Will work with providers to insure quality and appropriate care is being delivered in a… more
    Highmark Health (11/06/25)
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  • VP Pharmaceutical Trade Relations - REMOTE

    Prime Therapeutics (Lansing, MI)
    …decision we make. **Job Posting Title** VP Pharmaceutical Trade Relations - REMOTE **Job Description** The Vice President Pharmaceutical Trade Relations oversees the ... which address changing market demands and ensure Prime is delivering the highest quality and lowest cost of care to its members and related client messaging… more
    Prime Therapeutics (09/03/25)
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  • Care Review Clinician (RN)

    Molina Healthcare (Grand Rapids, MI)
    review , and medical coding. JOB DESCRIPTION Job SummaryProvides support for clinical member services review assessment processes. Responsible for verifying ... a (RN) Registered Nurse who must hold a compact license. This is a Remote position, home office with internet connectivity of high speed required Work Schedule… more
    Molina Healthcare (11/23/25)
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  • VBC Performance Specialist- Remote

    Sharecare (Lansing, MI)
    …for ensuring accurate, timely, and compliant reporting across multiple quality payment programs, including the Merit-based Incentive Payment System (MIPS) ... execution, and drive performance outcomes. + Ensure adherence to Qualified Clinical Data Registry (QCDR) guidelines, maintaining full compliance with all regulatory… more
    Sharecare (09/17/25)
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  • Senior Analyst, Network Strategy, Pricing…

    Molina Healthcare (MI)
    …partners through contract valuation and analysis to ensure access to quality healthcare services for people receiving government assistance. Strengthens access to ... quality care with improved outcomes through better coordination and...and ancillary) to deliver practical, actionable financial and even clinical insights to focus high priorities and attack underperforming… more
    Molina Healthcare (11/21/25)
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  • Senior Analyst, Network Strategy, Pricing…

    Molina Healthcare (Detroit, MI)
    …partners through contract valuation and analysis to ensure access to quality healthcare services for people receiving government assistance. Strengthens access to ... quality care with improved outcomes through better coordination and...and ancillary) to deliver practical, actionable financial and even clinical insights to focus high priorities and attack underperforming… more
    Molina Healthcare (10/25/25)
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  • Strategy, Growth and Development Manager…

    Trinity Health (Livonia, MI)
    …(eg, if acquisition) background, history, management, employees and culture, quality of earnings, mission/advocacy focus, market share, assets and cash ... and coordinating with other Trinity Health System Office functions to review /evaluate employee benefit issues, tax exposures, other liabilities and information… more
    Trinity Health (11/13/25)
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  • Care Management Processor Remote (Detroit,…

    Molina Healthcare (Detroit, MI)
    JOB DESCRIPTION Job Summary Provides non- clinical administrative support to the care management function, and contributes to interdisciplinary team efforts ... across the continuum. Contributes to overarching strategy to provide quality and cost-effective member care. **Must be able to...care management related services for members. * Facilitates initial review of assigned case levels and assists in case… more
    Molina Healthcare (11/04/25)
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