- Banner Health (MI)
- …areas assures compliance with coding rules and regulations according to regulatory agencies for state Medicaid plans, Center for Medicare Services (CMS), Office ... to apply your unique experience and expertise in support of a nationally-recognized healthcare leader. We offer stimulating and rewarding careers in a wide array of… more
- Highmark Health (Lansing, MI)
- …discipline. + Function in accordance with applicable state, federal laws and regulatory compliance . + Implement all care management reviews according to ... utilization management or a related field **SKILLS** + Working knowledge of pertinent regulatory and compliance guidelines and medical policies + Ability to… more
- Humana (Lansing, MI)
- …for improvements/changes. + In collaboration with market and enterprise partners, ensures compliance with the contract, CMS and Michigan Department of Health and ... experience, to include a combination of Utilization Management Case Management, and Managed Care. + 2+ years of leadership experience. + Knowledge of Medicare… more
- Intermountain Health (Lansing, MI)
- …collaborates with revenue producing departments, business office, revenue practice teams, HIM, managed care, and compliance constituents on related charge master ... related functions. This position is adept with Federal, State, CMS-OPPS, and regulatory /payer requirements and will update the chargemaster as needed. This position… more
- ChenMed (Warren, MI)
- …arrivals. This position adheres to strict departmental goals/objectives, standards of performance, regulatory compliance , quality patient care compliance and ... Case Manager Certification (CCMC) or the American Association of Managed Care Nurses (CMCN) desired + This position requires...90 days of employment We're ChenMed and we're transforming healthcare for seniors and changing America's healthcare … more
- Abbott (Sturgis, MI)
- Abbott is a global healthcare leader that helps people live more fully at all stages of life. Our portfolio of life-changing technologies spans the spectrum of ... healthcare , with leading businesses and products in diagnostics, medical...within the area. + Ensures all CAPA-related documentation is managed in a complete, clear, concise, and controlled manner.… more
- Grifols Shared Services North America, Inc (Muskegon, MI)
- …work performance and deliverables meet or exceed goals and objectives. + Ensures compliance with all applicable regulatory , legal, and operational rules and ... an international team working to improve the future of healthcare ? Do you want to enhance the lives of...to appropriate groups such as the following: key accounts, managed care organizations, integrated systems, national medical associations, and… more
- Prime Therapeutics (Lansing, MI)
- …communication, negotiation, and relationship management abilities + Knowledge of healthcare regulations, payer strategies, and compliance requirements + ... experience within medical and pharmacy drug management within a PBM or managed care organization, or oncology management experience if supporting oncology specialty… more
- Henry Ford Health System (Clinton Township, MI)
- …policies, regulatory and accreditation requirements, and standards. Assists in compliance with the accrediting and regulatory agencies (ie, Joint Commission, ... bachelor's degree is preferred. + Five (5) years in a hospital and/or managed care credentialing setting is required. + Medical staff services experience preferred.… more
- Prime Therapeutics (Lansing, MI)
- …skills and the ability to meet established deadlines **Preferred Qualifications** + Managed healthcare , health insurance, or other highly regulated industry + ... not limited to Internal Controls, Audit, Risk Assessments or Compliance + Must be eligible to work in the...(CIA, (CPA), (CFE), (CISA) + Experience researching and interpreting regulatory guidance **Physical Demands** + Ability to travel up… more
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