- Arab Community Center for Economic and Social Serv (Dearborn, MI)
- …o Oversee end-to-end management of all digital channels, including website content and functionality, social media strategy , and email/CRM systems, ensuring ... Summary: Under limited supervision, the Deputy Director serves as a department content expert utilizing specialized knowledge in operations management and… more
- CenterWell (Lansing, MI)
- …with prior experienceparticipatingin teams focusing on transitions of care, quality management ,utilizationmanagement, case management , discharge planning ... to innovate. **Additional Information** Will report to the Director of Physician Strategy at Utilization Management . The Medical Director conducts Utilization… more
- Molina Healthcare (Warren, MI)
- …and appeals. * Records calls accurately within the pharmacy call tracking system . * Maintains established pharmacy call quality and quantity standards. ... calls from members, providers, and pharmacies. Contributes to overarching pharmacy strategy for optimization of medication related health care outcomes, and … more
- Highmark Health (Lansing, MI)
- …ACO), alternative reimbursement models (eg, bundled payments), and provider / health plan quality programs (eg pay for performance) + 5 years Familiarity with ... Highmark Health Solutions, Health Plan Operations. **ESSENTIAL RESPONSIBILITIES** + Perform management responsibilities to include, but are not limited to: involved… more
- Henry Ford Health System (Detroit, MI)
- As the Director of Payer Audit - Revenue Cycle, you'll lead a high-performing, system -wide audit team and set the strategy for pre- and post-payment audit ... leveraging data to influence outcomes, and reducing financial risk across a $7B+ health system . If you're a proven leader with deep expertise in payer audits and a… more
- Molina Healthcare (Grand Rapids, MI)
- …Key areas of focus will include performance improvement, project planning and management , financial and operational analyses, corporate strategy development, and ... required **Required Experience** * Five years of experience in transformation, change management , strategy consulting, or internal corporate strategy . *… more
- Molina Healthcare (Grand Rapids, MI)
- …leader within the organization enterprise wide. This position advises senior management , other corporate departments, and Molina health plans on Risk Adjustment/RADV ... functions include, but may not be limited to: chart retrieval strategy , risk adjustment retrieval performance, process effectiveness, market performance, project… more
- Molina Healthcare (Saginaw, MI)
- …administrative cost effectiveness, member satisfaction - CAHPS, regulatory-related, Molina Quality programs , and taking advantage of electronic solutions ... and staff to determine, for example, non-compliance with Molina policies/procedures or CMS guidelines/regulations, or to assess the non-clinical quality of… more
- Molina Healthcare (Grand Rapids, MI)
- …and implementing operational physical security, threat/risk analytics and incident management programs supporting day-to-day services for Molina business ... the physical security controls, threat/risk analytics, and incident intake and crisis management support for the enterprise. This role drives and manages physical… more
- Humana (Lansing, MI)
- …position is a part of the HealthCare Economics team focused on evaluating programs and interventions related to Humana's Star Rating measure performance. You will be ... resolutions for data anomalies. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas.… more
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