- Molina Healthcare (Detroit, MI)
- **Job Description** **Job Summary** Establish a specifically designed compliance program that effectively prevents and/or detects violation of applicable laws and ... the Health Care environment. Ensures the Business' accountability for compliance by overseeing, follow-up and resolution of investigations. **Knowledge/Skills/Abilities**… more
- CVS Health (Lansing, MI)
- …it all with heart, each and every day. **Job Description** + The Sr. Manager , Medicare Sales Strategy develops and executes strategic initiatives to drive sales ... Medicare Advantage organizations, as well as operations, enrollment, compliance and finance + Mastery of Medicare ...enrollment, compliance and finance + Mastery of Medicare Sales and Marketing compliance guidelines and… more
- Molina Healthcare (Ann Arbor, MI)
- …of the benefits, operations, communication, reporting, and data exchange of the Medicare product in support of strategic and corporate business objectives. Develops ... infrastructure, standards, and policies and procedures for the Medicare and Dual Eligible Program and participates in the strategic development of its products and… more
- Molina Healthcare (Ann Arbor, MI)
- …Enrollment activities (along with other Core Ops areas of responsibilities) within Medicare and Medicaid. Role is predicated on building relationships with vendors, ... vendor performance involving onshore and offshore resources, monitors regulatory compliance adherence (in conjunction with functional counterparts) and quality… more
- Molina Healthcare (Ann Arbor, MI)
- …business areas and owners to ensure processes and reporting exists to demonstrate compliance to regulatory requirements. * Supports Manager and Director with ... to assess, oversee, and recommend business practices to ensure adherence to and compliance with State and Federal regulatory guidelines. The Sr. Analyst develops and… more
- Molina Healthcare (Ann Arbor, MI)
- …speed to answer, and average hold time are compliant with Centers for Medicare and Medicaid Services (CMS) regulations. + Ensures that adequate staffing coverage is ... leadership with monitoring and oversight of Molina's contracted Pharmacy Benefit Manager (PBM) for pharmacy contractually delegated functions. + Responsible for key… more
- Molina Healthcare (Detroit, MI)
- …achieve operational goals and executes tasks and projects to ensure Centers for Medicare & Medicaid Services (CMS) and State regulatory requirements are met for ... complex business challenges that impact cost containment and regulatory compliance . The position requires strong business judgment, cross-functional coordination,… more
- Gentiva (Portage, MI)
- …benefit package. Read on to learn more! We're looking for a **Patient Care Manager Senior/Clinical Manager ** to join our team. You will report directly to ... developing associates and ensuring adherence to company policies and procedures and compliance with local, state, and federal regulations and regulatory agencies. +… more
- Humana (Lansing, MI)
- …develop engagement best practices, and design clinical solutions for members who have Medicare and Medicaid. The Lead Product Manager partners across various ... our dual members - members that qualify for both Medicare and Medicaid. The Lead Product Manager ...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
- Molina Healthcare (MI)
- …achieve operational goals and executes tasks and projects to ensure Centers for Medicare & Medicaid Services (CMS) and State regulatory requirements are met for ... complex business challenges that impact cost containment and regulatory compliance . The position requires strong business judgment, cross-functional coordination,… more