- CenterWell (Lansing, MI)
- …The Director is response for the strategic direction, execution and ongoing management of our High Risk Patient Management (HRPM) program, Transitions ... quality improvement activities to address high risk, high-utilizers/high-cost patient management through the utilization of the 5M's...primary care, one of the largest providers of home health services, and fourth largest pharmacy… more
- Sumitomo Pharma (Lansing, MI)
- …seeking a qualified, highly motivated, experienced individual for the position of **National Corporate Account Director (NCAD).** The position currently ... years of experience managing oncology/urology GPOs, with at least 5 years of combined experience in account management , sales, market access and/or payer… more
- Molina Healthcare (Grand Rapids, MI)
- …and group providers and medical managers regarding utilization practices, guideline usage, pharmacy utilization and effective resource management . + Develops and ... contracting experience. + Experience with NCQA, HEDIS, Medicaid, Medicare and Pharmacy benefit management , Group/IPA practice, capitation, HMO regulations,… more
- Humana (Lansing, MI)
- …backdrop, we are seeking an accomplished healthcare physician leader for the newly-created role of Director , Physician Leadership. In this role, you will be a ... key enterprise leader, with responsibility for evolving Humana's Utilization Management of medical review by physician or nurse, with a focus on our 5+ million… more
- Henry Ford Health System (West Bloomfield, MI)
- …and preventative care to complex and specialty care, health insurance, a full suite of home health offerings, virtual care, pharmacy , eye care and other health ... Henry Ford Health is currently seeking an Emergency Department Director to join our team. This nursing leader has...team. This nursing leader has overall responsibility for all of the activities within the Emergency Department. They are… more
- Centene Corporation (Lansing, MI)
- …fresh perspective on workplace flexibility. **Position Purpose:** Assist the Chief Medical Director to direct and coordinate the medical management , quality ... functions for the business unit. + Provides medical leadership of all for utilization management , cost containment,...corporate, and accreditation requirements. + Assists the Chief Medical Director in the functioning of the physician… more
- Prime Therapeutics (Lansing, MI)
- …Title** Sr. Director Actuarial Forecasting - REMOTE **Job Description** The Senior Director of Actuarial Forecasting leads a team of actuaries ... business solutions to clients' complex pharmacy benefit challenges + Strong understanding of pharmacy plan design **Physical Demands** + Ability to travel up… more
- Molina Healthcare (Ann Arbor, MI)
- …compliance by owning Molina's entire CMS Complaints Tracking Module (CTM) life cycle. As Director of CTM Oversight & Resolution you set the standards and ... Enrollment, Claims, Pharmacy /PDE, Network, Stars quality metrics. * Proven record of closing process gaps and delivering durable improvements in a matrixed or… more
- Prime Therapeutics (Lansing, MI)
- …**Job Posting Title** Director , Underwriting - REMOTE **Job Description** The Director of Underwriting is responsible for leading the Underwriting team ... oversight of both direct and carve-in lines of business. The Director is also responsible...of related experience and/or training + 5 years of leadership/people management experience + Must be… more
- Prime Therapeutics (Lansing, MI)
- …Suite **Preferred Qualifications** + Master's degree or other advanced degree + 3 years of Pharmacy Benefit Management (PBM) experience Every employee must ... market problems facing Prime's clients, cross-functionally leading the development and management of highly complex products and initiatives, and proving the… more