- Intermountain Health (Lansing, MI)
- …be necessary, regardless of state of residence, and will primarily be within Intermountain Health 's service area (UT, ID, NV, CO, WY, MT), but may also require ... Corporate / Central office b) Intermountain Healthcare's hospitals c) Home Care d) Medical Group e) Life Flight f)...Care d) Medical Group e) Life Flight f) Select Health Job Essentials 1) Directs efforts between key stakeholders… more
- Evolent (Lansing, MI)
- …experience and as an RN - **Required** + Minimum of 5 years in Utilization Management, health care Appeals, compliance and/or grievances/complaints in a quality ... **Your Future Evolves Here** Evolent partners with health plans and providers to achieve better outcomes...appeals and post-determination requests. We maintain the principles of utilization management by adhering to Evolent and Client policies… more
- Evolent (Lansing, MI)
- **Your Future Evolves Here** Evolent partners with health plans and providers to achieve better outcomes for people with most complex and costly health ... care, we seek to connect the pieces of fragmented health care system and ensure people get the same...appeals and post-determination requests. We maintain the principles of utilization management by adhering to Evolent and client policies… more
- Evolent (Lansing, MI)
- **Your Future Evolves Here** Evolent partners with health plans and providers to achieve better outcomes for people with most complex and costly health ... care, we seek to connect the pieces of fragmented health care system and ensure people get the same...by performing medical economics analyses to determine cost and utilization drivers. Showcase standard stack of reporting capabilities while… more
- Evolent (Lansing, MI)
- **Your Future Evolves Here** Evolent partners with health plans and providers to achieve better outcomes for people with most complex and costly health ... care, we seek to connect the pieces of fragmented health care system and ensure people get the same...membership data, and clinical outcomes to uncover cost drivers, utilization trends, and opportunities for integrated care solutions using… more
- Humana (Lansing, MI)
- …quality management, utilization management, case management, discharge planning and/or home health or post-acute services such as inpatient rehabilitation. ... Director relies on fundamentals of CMS Medicare Guidance on following and reviewing home health , DME, skilled nursing facility and waiver requests. The Medical… more
- BrightSpring Health Services (Southgate, MI)
- …shape behavior by celebrating those small, every day successes. Gateway provides home and clinic-based ABA services for children with Autism Spectrum Disorders, ... guidelines set forth by the specific insurance company or community mental health organization in addition to the specifications listed within Gateway policies and… more
- Humana (Lansing, MI)
- …quality management, utilization management, case management, discharge planning and/or home health or post acute services such as inpatient rehabilitation. ... **Become a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The Medical… more
- Humana (Lansing, MI)
- …quality management, utilization management, case management, discharge planning and/or home health or post-acute services (such as inpatient rehabilitation). ... **Become a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The Medical… more
- Humana (Lansing, MI)
- …quality management, utilization management, case management, discharge planning and/or home health or post acute services such as inpatient rehabilitation. ... **Become a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The Medical… more