• Deputy General Counsel, Litigation - REMOTE

    Prime Therapeutics (Lansing, MI)
    …(corporate governance, dispute resolution, contract negotiation, employment law, audits/investigations, regulatory compliance ) + 3 years of experience advising ... visa or residency sponsorship **Additional Qualifications** + Advanced knowledge of PBM regulatory frameworks and healthcare law, with demonstrated ability to… more
    Prime Therapeutics (07/19/25)
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  • Network Contract Manager CIN - Full time

    Henry Ford Health System (Detroit, MI)
    …monitor and report contractual terms. This role is essential in maintaining compliance with regulatory requirements and supporting the continuous improvement of ... Healthcare Administration, or similar field required. . Three (3) years of healthcare industry experience, preferably in managed care, or Accounting, Finance,… more
    Henry Ford Health System (06/13/25)
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  • Medical Director - Mid West Region

    Humana (Lansing, MI)
    …site of service should be authorized. All work occurs within a context of regulatory compliance , and work is assisted by diverse resources, which may include ... medical interpretation and determinations whether services provided by other healthcare professionals are in agreement with national guidelines, CMS requirements,… more
    Humana (05/14/25)
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  • Medical Director - Care Plus - Florida

    Humana (Lansing, MI)
    …site of service should be authorized. All work occurs with a context of regulatory compliance , and work is assisted by diverse resources which may include ... medical interpretation and determinations whether services provided by other healthcare professionals are in agreement with national guidelines, CMS requirements,… more
    Humana (06/28/25)
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  • Contract Specialist Lead

    Corewell Health (Grand Rapids, MI)
    …and external customers. The successful candidate will understand the nuances of managed care contracting, analytics, managed care payers, delivery system's ... to engage senior leaders. The candidate will also understand the latest healthcare trends and leverage their past years of experience to creatively design… more
    Corewell Health (06/19/25)
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  • Medical Director - South Carolina SE Region

    Humana (Lansing, MI)
    …site of service should be authorized. All work occurs within a context of regulatory compliance , and work is assisted by diverse resources, which may include ... medical interpretation and determinations whether services provided by other healthcare professionals are in agreement with national guidelines, CMS requirements,… more
    Humana (07/22/25)
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  • Manager Special Investigation Unit

    Corewell Health (Grand Rapids, MI)
    …abuse experience or equivalent combination of; auditing, healthcare fraud and abuse, compliance , or regulatory (ie, CMS & Medicaid) experience Required + 5 ... SIU team, ensuring the effective execution of investigative strategies and compliance with regulatory requirements.Key responsibilities include managing vendor… more
    Corewell Health (07/19/25)
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  • Contract Management Analyst

    AmeriHealth Caritas (Detroit, MI)
    …federal managed health care requirements + 3 to 5 years in a managed care-related or healthcare industry + Proven experience with contract management tools ... (ie, we use Contract Manager, Emptpros) + Proficiency in researching regulatory requirements and managed care industry best practices **Skills & Abilities;** +… more
    AmeriHealth Caritas (07/27/25)
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  • Manager Payment Integrity

    Corewell Health (Grand Rapids, MI)
    … Healthcare claim auditing or equivalent combination of; auditing, medical coding, healthcare revenue cycle, or regulatory (ie, CMS & Medicaid) experience + ... across key business functions. The ideal candidate will bring deep expertise in healthcare operations and a strong command of project management principles. You will… more
    Corewell Health (07/18/25)
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  • Analyst Case Management

    CVS Health (Lansing, MI)
    …and Documentation:** Adhere to case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies. ... and productivity metrics, including call volume, successful member engagement, and compliance with state/federal regulatory requirements. + Conduct oneself with… more
    CVS Health (07/18/25)
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