- Humana (Lansing, MI)
- **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to make ... well as a focus on collaborative business relationships, value-based care, population health , or disease or care management. Medical Directors support Humana values… more
- Trinity Health (Livonia, MI)
- …If applicable, telecommuting (working remotely), must be able to comply with Trinity Health 's and the Region/HM Working Remote Policy. **Hourly Pay Range:** ... documentation contained in assigned Emergency Department (ED) and Outpatient Observation health records (electronic, paper or hybrid) to determine the principal… more
- Trinity Health (Livonia, MI)
- …and subject matter expertise analyzing physician/provider documentation in Inpatient health records to determine the principal diagnosis, secondary diagnoses, ... ESSENTIAL FUNCTIONS: 1. Knows, understands, incorporates, and demonstrates the Trinity Health Mission, Vision, and Values in behaviors, practices, and decisions. 2.… more
- Otsuka America Pharmaceutical Inc. (Lansing, MI)
- … health backgrounds (eg licensed therapists, clinical psychologists, behavioral health specialists , Nurse Practitioners and Physician Assistants in behavioral ... health **Must live in IA, MO, KS, NE** **\#LI- Remote ** **Competencies** **Accountability for Results -** Stay focused on...you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more
- Otsuka America Pharmaceutical Inc. (Lansing, MI)
- …and drive the ecosystem commercial strategy. + Lead a team of Neuroscience Specialists within an ecosystem to drive appropriate clinical demand and improve patient ... sources (eg, analytics) to inform regional business plans. + Coach Neuroscience Specialists to shape customer plans based on market dynamics to address customer… more
- Banner Health (MI)
- …with State Pay Transparency Rules. Innovation and highly trained staff. Banner Health recently earned Great Place To Work(R) Certification (TM) . This recognition ... Find out how we're constantly improving to make Banner Health the best place to work and receive care....A typical day would include overseeing RN denials mgt specialists and Audit team, posting bill reviews, and managing… more
- Molina Healthcare (Warren, MI)
- …Looking for a RN that has a current active unrestricted license This a remote role and can sit anywhere within the United States. Work Schedule Monday to ... work on set schedule) Looking for a RN with experience with appeals, claims review, and medical coding. **Job Summary** Utilizing clinical knowledge and experience,… more
- Lincoln Financial (Lansing, MI)
- **Alternate Locations:** Work from Home **Work Arrangement:** Remote : Work at home employee residing outside of a commutable distance to an office location. ... be responsible for reviewing, analyzing, and interpreting medical information available for disability claims . In this role you will act as a clinical resource for… more
- Molina Healthcare (Grand Rapids, MI)
- **_ Remote and must live in Michigan _** **Job Description** **Job Summary** Molina Health Plan Provider Network Contracting (Long Term Support Services, LTSS) ... for accurate and timely maintenance of critical provider information on all claims and provider databases. Synchronizes data among multiple claims systems… more
- WTW (Grand Rapids, MI)
- …aligned with clients' needs and partnering with the industry's top technical specialists , to win and retain the business. Note: Employment-based non-immigrant visa ... phone and face to face with clients. + Champion the proper advocacy of claims . + Participate in stewardship meetings. + Support Client Management team in identifying… more