- Prime Healthcare (Port Huron, MI)
- …Healthgrades Patient Safety Excellence Award, rated four stars by the Centers for Medicare & Medicaid Services and earned The Joint Commission's Gold Seal of ... Approval(R) for Hospital Accreditation by demonstrating continuous compliance with its performance standards. Learn more atwww.mylakehuron.com. As a member of Prime… more
- CVS Health (Dearborn, MI)
- …models. You can have life-changing impact on our members who are enrolled in Medicare and Medicaid and present with a wide range of complex health and social ... at interdisciplinary case conferences. + Utilizes case management processes in compliance with regulatory and company policies and procedures. + Utilizes… more
- McLaren Health Care (Flint, MI)
- We are looking for a MIG Manager Claims, to join us in leading our organization forward. McLaren Integrated HMO Group (MIG) is a fully owned subsidiary of McLaren ... Indiana-based health plan, working with the State of Indiana and Centers for Medicare and Medicaid Services to bring you the Hoosier Healthwise and Healthy Indiana… more
- CVS Health (Lansing, MI)
- …Certification - Lean Six Sigma (Green/Black Belt) - Tableau Dashboards/Analytics - Medicare / Medicaid experience -Experience with HEDIS Metrics, CAHPS Member ... Satisfaction Surveys, NCQA Accreditation, Compliance Audits and/or MI State Reporting / ... Compliance Audits and/or MI State Reporting / Compliance **Education** . Bachelor's degree or equivalent managed care… more
- CVS Health (Lansing, MI)
- …issues. + Manages operational aspects of the team (eg, budget, performance, and compliance ), and implements workforce and succession plans to meet business needs. + ... of 3 years managing/leading a team. + Experience working in Medicare , Medicaid, or Commercial Health Insurance. **Preferred Qualifications** + Experience working… more
- Munson Healthcare (Manistee, MI)
- …Commission (TJC) EOC, EM and Life Safety standards, The Centers for Medicare and Medicaid Services (CMS) requirements, Michigan Occupational Safety and Health ... safety and environment of care, security and emergency management.Oversees and manages compliance with all applicable regulations including but not limited to TJC,… more
- Molina Healthcare (Detroit, MI)
- …and supervision of daily functional operations to insure compliance to contract requirements. **Knowledge/Skills/Abilities** * Oversees budget responsibilities ... type management responsibility. 5 years progressive experience supporting a Medicaid,. Medicare and Marketplace or large claims processing environment with… more
- Humana (Lansing, MI)
- …necessary. + Participate in special projects as assigned by your Supervisor or Manager **Use your skills to make an impact** **Required Qualifications** + Bilingual ... recognized leader in healthcare delivery that has been offering Medicare Advantage health plans in Florida over 23 years....the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
- Corewell Health (Dearborn, MI)
- …pm Job Summary Under the direction of the Patient Access Registration Front Line Manager , the Acute Care Hospital Registrar 1 is accountable to ensure a smooth ... information, educating and providing information as necessary. Collects and documents Medicare Questionnaire, issue Medicare Inpatient Letter & Medicare… more
- University of Michigan (Ann Arbor, MI)
- …Facility Patient Assessment Instrument (IRF-PAI) in accordance with Centers for Medicare and Medicaid Services. This individual utilizes specialty knowledge of IRF ... Medicare rules and regulations to support compliant billing for...to maximize reimbursement, ensure IRF QRP (Quality Reporting Program) compliance and accuracy, as well as 60% compliance… more