- Molina Healthcare (Detroit, MI)
- …+ 3 - 5 years customer service, provider service, or claims experience in a managed care setting. + 3-5 years' experience in managed healthcare ... in negotiating different provider contract types, ie, physician, group and hospital contracting , etc. + Working familiarity with various managed healthcare… more
- Evolent (Lansing, MI)
- …and proficiency + Personally initiate and foster executive level relationships at managed care organizations or health systems and large provider groups ... cycles requiring diverse stakeholder management + Knowledge of the managed care and provider markets (both payers...for healthcare and subscribed to the vision of value-based care + Strong familiarity with risk-based contracting … more
- CVS Health (Lansing, MI)
- …or be willing to relocate to Michigan. + 10+ years of experience in managed care ; leading and managing teams. + Comprehensive understanding of hospital and ... ourselves with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions company, we reach millions… more
- Prime Therapeutics (Lansing, MI)
- …including pharmaceutical manufacturers, with specific emphasis on Medicare Part D and Managed Medicaid. The Sr Director, Pharm Trade Relations leads a team of ... issues, contract analysis, and contract language needs in rebate contracting . + Serve as a government affairs expert including...experience within the PBM industry, with expert knowledge of Managed Medicaid, Medicare Part D, and health plans +… more
- Sanofi Group (Detroit, MI)
- …their assigned accounts. Efforts will include working with national headquarters of managed care organizations and leading pull-through strategies to local ... as well as initiatives with other large and local managed care organizations. The Regional Account Director...closely with the Sanofi Value and Access, Pricing and Contracting , Analytics, PSS, case management, reimbursement support (ie, FRMs,… more
- Evolent (Lansing, MI)
- …discussions . Experience building and developing team members . Knowledge of the managed care and oncology market trends (both payers and risk-bearing ... organizations) . Passion for healthcare and subscribed to the vision of value-based care . Strong familiarity with risk-based contracting . Thrives in an… more
- CVS Health (Lansing, MI)
- …and health care industry. At least three years of experience Medicaid and managed care experience. Must be a physician with a current, unencumbered license ... Qualifications** 1. Demonstrated experience in population health management and Managed Care . 2. Passion and ability to...outcomes in healthcare delivery. 3. Understanding of Value Based Contracting /Accountable Care and how this relates to… more
- Molina Healthcare (Sterling Heights, MI)
- …guidelines. + Experience in Utilization/Quality Program management + HMO/ Managed care experience **PREFERRED LICENSE, CERTIFICATION, ASSOCIATION:** ... and action plan, which includes strategies that ensure a high quality of patient care , ensuring that patients receive the most appropriate care at the most… more
- Molina Healthcare (Detroit, MI)
- …10+ years relevant experience, including 5+ years of clinical practice and 3+ years HMO/ Managed Care experience **OR** 5 years experience as a Molina Medical ... inpatient concurrent review, discharge planning, case management and interdisciplinary care team activities. + Ensures that authorization decisions are rendered… more
- University of Michigan (Northville, MI)
- …coding questions, responding to billing inquiries, and assisting with insurance authorizations and managed care -related issues. + Work in basket messages. + Send ... terminology. + Prior experience with patient insurance, hospital billing, collection and managed care concepts and referrals. + Exceptional interpersonal skills… more