- Humana (Lansing, MI)
- …be required to work in either Central or Eastern Time. Associate Director, Regulatory Intake Compliance is responsible for enterprise-wide regulatory ... risk exposure for the organization. The Associate Director, Regulatory Intake Compliance will be responsible for/to:...years of management experience + Advanced experience working in compliance , risk management, or managed -care field +… more
- Molina Healthcare (Grand Rapids, MI)
- …review. The position may also work with other internal departments, including Compliance , Corporate Legal Counsel, and Medical Officers in order to achieve and ... various internal customers (eg, Provider Services, Contracting and Credentialing, Healthcare Services, Member Services, Claims) to gather documentation pertinent to… 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 (Ann Arbor, MI)
- …Degree in Healthcare Administration **Preferred Experience** + 10 years of managed care experience ( Regulatory and Compliance ) + Previous management ... Administration such as oversight, audit, etc. **Required Experience** * 7 years of managed care experience ( Regulatory and Compliance ) * Previous management… 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)
- …dynamics, and the latest Medicaid trends, positioning Molina as a leader in Medicaid managed care + Track regulatory compliance and address any operational ... and experience + 7 years in market strategy, business development, or healthcare consulting, specifically within Medicaid managed care or equivalent related… 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 (Warren, MI)
- …environment. * 3+ years experience in provider contract negotiations in a managed healthcare setting ideally in negotiating different provider contract types, ... group and hospital contracting, etc. * Working familiarity with various managed healthcare provider compensation methodologies, primarily across Medicaid and… more
- DuPont (Hemlock, MI)
- …System Software Validation to ensure new systems and system changes are managed consistently with regulatory & business requirements. + Support cross-functional ... Quality Improvement initiatives (short-term & long-term) for our Liveo (TM) Healthcare operations; this involves supporting our customers and production sites. This… more