• Project Manager - Healthcare Claims…

    Integra Partners (Troy, MI)
    The Project Manager - Healthcare Claims Management (Subject Matter Expert) is responsible for leading complex projects and initiatives related to claims ... improvements. This role requires deep subject matter expertise in healthcare claims systems, workflows, and regulatory requirements. The PM will collaborate with… more
    Integra Partners (09/18/25)
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  • Client Performance Manager - Workers…

    Sedgwick (Grand Rapids, MI)
    …Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Client Performance Manager - Workers Compensation | Remote | Travel Required Are you ... Apply your knowledge and experience to adjudicate complex customer claims in the context of an energetic culture. +...adherence to client service instructions and timely distribution of claims reports. + Monitor client reserves and average claim… more
    Sedgwick (10/14/25)
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  • Test Manager ( Remote )

    GovCIO (Lansing, MI)
    **Overview** GovCIO is currently hiring for a Test Manager tooversee the testing strategy, planning, and execution across a portfolio of healthcare systems, ensuring ... data privacy regulations (eg, HIPAA), and interoperability standards. The Test Manager collaborates with cross-functional teams to ensure that all systems meet… more
    GovCIO (10/01/25)
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  • Manager , Medical Economics (Medicaid)…

    Molina Healthcare (Ann Arbor, MI)
    **JOB DESCRIPTION** **Job Summary** The Manager , Medical Economics provides support and consultation to the Health Plan and Finance team through analyzing key ... executive decision-making + Mine and manage information from large data sources. + Analyze claims and other data sources to identify early signs of trends or other… more
    Molina Healthcare (08/27/25)
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  • Manager , Healthcare Analytics - Health…

    Molina Healthcare (Sterling Heights, MI)
    …or team leadership experience + 10 years' work experience preferable in claims processing environment and/or healthcare environment + Strong knowledge of SQL ... 2005/2008 SSRS report development + Familiar with relational database concepts, and SDLC concepts **Preferred Education** Masters' Degree in Finance, Economics, Math, Computer Science, Information Systems, or related field. **Preferred Experience** 3 - 5 years… more
    Molina Healthcare (10/04/25)
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  • Sr. AI Business Analyst - Remote

    Prime Therapeutics (Lansing, MI)
    …drives every decision we make. **Job Posting Title** Sr. AI Business Analyst - Remote **Job Description** **Are you a Business Systems Analyst with an AI background? ... to elicit, define, and document the requirements for changes to Prime's claims systems. **Responsibilities** + Ensure understanding of business requirements and IT… more
    Prime Therapeutics (10/01/25)
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  • Lead Analyst, Payment Integrity - REMOTE

    Molina Healthcare (MI)
    …and executing operational initiatives tied to Payment Integrity (PI) and provider claims accuracy. The individual will be relied upon to make independent, informed ... a business lens to ensure accurate interpretation of provider claims trends, payment integrity issues, and process gaps. +...years of experience as a Business Analyst or Program Manager in a Managed Care Organization (MCO) or health… more
    Molina Healthcare (09/28/25)
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  • Family Health Advocate - Remote

    Sharecare (Lansing, MI)
    …The role of the Family Health Advocate is an exciting and innovative remote role newly created to provide meaningful support to members and their families ... eligibility, benefit education, open enrollment / new hire plan selection, claims issues, ID card issues, grievances/appeals, utilization management (UM) status,… more
    Sharecare (10/14/25)
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  • Director, Appeals & Grievances ( Remote )

    Molina Healthcare (Ann Arbor, MI)
    …appeals experience. **Required Experience** * 7 years experience in healthcare claims review and/or member appeals and grievance processing/resolution, including 2 ... years in a manager role. * Experience reviewing all types of medical claims (eg HCFA 1500, Outpatient/Inpatient UB92, Universal Claims , Stop Loss, Surgery,… more
    Molina Healthcare (09/26/25)
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  • Billing Specialist II (Experienced) Full Time/…

    Henry Ford Health System (Troy, MI)
    …of patient financial, insurance and demographic patient information to ensure compliant claims to Third party payers. Resolves problem accounts from payer denials ... and follows up on any claims that require a payer response. Responsible for the...+ Ability to communicate effectively with colleagues, supervisor, and manager . + Ability to work independently. + Strong organizational… more
    Henry Ford Health System (10/01/25)
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