- Molina Healthcare (MI)
- …provider contract, network development and management, or project management experience in a managed healthcare setting. **Required Experience** + 2 - 3 years ... in a managed care setting. + Working familiarity with various managed healthcare provider compensation methodologies, primarily across Medicaid and Medicare… more
- Highmark Health (Lansing, MI)
- …healthcare operations, risk, audit, or legal functions + 5 years in Healthcare Compliance or Privacy **LICENSES or CERTIFICATIONS** **Required** + None ... rules as well as a solid working knowledge of managed care operations, compliance program structures, information...(CIA) + Certified Fraud Examiner (CFE) + Certified in Healthcare Compliance (CHC) + Certified Compliance… more
- Molina Healthcare (MI)
- …network development and management, or project management experience in a managed healthcare setting. **REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES** : ... in a managed care setting. * Working familiarity with various managed healthcare provider compensation methodologies, primarily across Medicaid and Medicare… more
- Molina Healthcare (Detroit, MI)
- …Participate in process improvement initiatives to improve operations + Understands the compliance and regulatory guidelines for each state + Maintains ... coaching, production and appropriate terminations. + Ensures staff is compliant with regulatory and company guidelines, including HIPAA compliance . + Responsible… more
- Molina Healthcare (Sterling Heights, MI)
- …in resolving complex business challenges that impact cost containment and regulatory compliance . The position requires strong business judgment, cross-functional ... trends, payment integrity issues, and process gaps. + Applies understanding of healthcare regulations, managed care claims workflows, and provider reimbursement… more
- Molina Healthcare (Grand Rapids, MI)
- …in resolving complex business challenges that impact cost containment and regulatory compliance . The position requires strong business judgment, cross-functional ... trends, payment integrity issues, and process gaps. + Apply understanding of healthcare regulations, managed care claims workflows, and provider reimbursement… more
- NTT America, Inc. (Detroit, MI)
- …services, and industry vertical solutions to include things like regulatory compliance solutions, digital solutions, mobile solutions, transformational ... apply now. We are currently seeking a **IT Services Sales Executive ( Healthcare Payer Vertical)** to join our team Remotely. Location is open, preference… more
- Corewell Health (Grand Rapids, MI)
- …management and board governance, offering guidance and practical solutions to complex regulatory compliance challenges . As Corewell Health's Chief Privacy ... of Directors (primarily via the CRC) to effectively incorporate regulatory compliance within the culture, operations and...octorate law degree or other relevant masters/graduate degree + Healthcare Compliance , Certified (CHC) - HCCA Health… more
- Henry Ford Health System (Detroit, MI)
- …identifying risks, establishing compliance monitoring processes, and assessing regulatory compliance of HFH operations. PRINCIPLE DUTIES AND ... compliance auditing and monitoring to assess and identify compliance risks with Federal and State regulatory ... compliance audit program initiatives. + Experience conducting compliance audits of a large multi-facility healthcare … more
- Molina Healthcare (Sterling Heights, MI)
- …or utilization management experience. + 3+ years supervisory experience in a managed healthcare environment. + Previous experience in Hospital Acute Care, ... non-clinical team activities to facilitate integrated, proactive utilization management, ensuring compliance with regulatory and accrediting standards. + Manages… more
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