- Prime Therapeutics (Lansing, MI)
- …and drives every decision we make. **Job Posting Title** Enterprise Risk Management Analyst - Remote **Job Description** The Enterprise Risk Management Analyst ... and the ability to meet established deadlines **Preferred Qualifications** + Managed healthcare, health insurance, or other highly regulated industry + Experience… more
- Henry Ford Health System (Troy, MI)
- GENERAL SUMMARY: Under supervision of Manager and / or Director, support the managed care contracting function by performing necessary financial analysis to ... field. + Minimum of four (4) years in the Healthcare industry in Managed Care Contracting, Provider Relations, Provider Reimbursement or related professional… more
- Molina Healthcare (Grand Rapids, MI)
- …adjudication, QNXT system navigation, and strong analytical acumen. Experience in Medicaid managed care is required, and a background in payment integrity-either ... **Job Description** **Job Summary** We are seeking a highly experienced Lead Analyst , Configuration Oversight to support our Payment Integrity and Claims Operations… more
- Evolent (Lansing, MI)
- …experience in claims-based healthcare analytics with a payer, provider, clinical vendor, managed care , or related healthcare consulting entity + Ability to ... and costly health conditions. Working across specialties and primary care , we seek to connect the pieces of fragmented...we seek to connect the pieces of fragmented health care system and ensure people get the same level… more
- Highmark Health (Lansing, MI)
- …+ High school diploma /GED + 3 years of experience required in health care / managed care + 3 years of experience in credentialing/re-credentialing of ... practitioners/providers + 3 years of experience with NCQA and other regulatory standards **Substitutions** + None **Preferred** + Bachelor's degree. + Certified Provider Credentialing Specialist (CPCS) certification **Skills** + None **SCOPE OF… more
- Molina Healthcare (Detroit, MI)
- …**Required Experience** + 5-7 years of business analysis experience, + 6+ years managed care experience. + Demonstrates proficiency in a variety of concepts, ... practices, and procedures applicable to job-related subject areas. **Preferred Education** Bachelor's Degree or equivalent combination of education and experience **Preferred Experience** + 3-5 years of formal training in Project Management + Experience… more
- Molina Healthcare (Detroit, MI)
- …and experience **Required Experience** + 3-5 Years of business analysis + 4+ years managed care experience + Demonstrates familiarity in a variety of concepts, ... practices, and procedures applicable to job-related subject areas. **Preferred Education** Bachelor's Degree or equivalent combination of education and experience **Preferred Experience** + 1-3 years formal training in Business Analysis and/or Systems Analysis… more
- Molina Healthcare (MI)
- …**Required Experience** + 5-7 years of business analysis experience, + 6+ years managed care experience. + Demonstrates proficiency in a variety of concepts, ... practices, and procedures applicable to job-related subject areas. **Preferred Education** Bachelor's Degree or equivalent combination of education and experience **Preferred Experience** + 3-5 years of formal training in Project Management + Experience… more
- Molina Healthcare (Grand Rapids, MI)
- …years of experience as a Business Analyst or Program Manager in a Managed Care Organization (MCO) or health plan setting, or equivalent combination of ... integrity issues, and process gaps. + Apply understanding of healthcare regulations, managed care claims workflows, and provider reimbursement models to shape… more
- Presbyterian Villages of Michigan (Southfield, MI)
- …capital financing, facilities compliance for senior housing, assisted living, memory care , and life plan communities, and other facilities owned, leased, and/or ... managed by Presbyterian Villages of Michigan (PVM) which advance...Director of Real Estate, FA Project Manager, and Project Analyst in managing all real estate and development related… more