- Prime Therapeutics (Lansing, MI)
- …or PBM organization, or other highly regulated industry, including experience with Medicare, Medicaid , and the Affordable Care Act (ACA) + Must be eligible to work ... skills **Preferred Qualifications** + PBM/health care experience related to Medicare, Medicaid , Commercial, HIM + Certified Compliance and Ethics Professional (CCEP)… more
- Prime Healthcare (Port Huron, MI)
- …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 ... and The Conditions of Participation by The Centers for Medicare and Medicaid Services (CMS). Qualifications EDUCATION, EXPERIENCE, TRAINING 1. Bachelors of Science… more
- Humana (Lansing, MI)
- …clinical experience + Knowledge of the managed care industry including Medicare, Medicaid and/or Commercial products + Must be passionate about contributing to an ... are leading to a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at large. **Equal… more
- State of Michigan (MI)
- …survey and certification activities on behalf of the Centers for Medicare and Medicaid Services (CMS). The health care surveyor position performs surveys for covered ... Minimum Qualifications Test (SMQT) in accordance with the Centers for Medicare and Medicaid Services' standards and procedures. All positions must abide by state law… more
- Molina Healthcare (MI)
- …and clinical performance is achieving desired results + Keep abreast of Medicaid and Medicare reforms and their impact on Molina Healthcare **Job Qualifications** ... + 5+ years of related experience in healthcare + Demonstrated understanding of Medicaid and Medicare programs or other healthcare plans + Analytical work experience… more
- Trinity Health (Grand Rapids, MI)
- …position work on a team with Nurses and Community Health Workers to case manage Medicaid eligible pregnant women and infants up to age one and their families. The ... topics and available services + Collaborate with interdisciplinary teams and Medicaid Health Plans + Accurately document assessments, plans, interventions, and… more
- Marshfield Clinic (Iron Mountain, MI)
- …clinics within the Health System. This individual will assist with Medicare and Medicaid Cost Report coordination, Wage Index, S10, DSH and other governmental audits ... excluded from participation in any federally funded program, including Medicare and Medicaid . This is a condition of employment. Employee must immediately notify… more
- Molina Healthcare (MI)
- …evaluate, and submit encounter deletions for Medicare Advantage, ACA, and Medicaid lines of business. This role has decision-making accountability for ensuring ... or above. + Extensive understanding of Medicare Advantage, ACA and Medicaid risk adjustment processes, including encounter data submission and deletion requirements… more
- Molina Healthcare (Warren, MI)
- …or equivalent combination of relevant education and experience + Medicare and/or Medicaid Managed Care experience + Quantitative aptitude + Strong leadership in a ... experts, and external resources. **PREFERRED QUALIFICATIONS:** + Integrated products ( Medicaid -Medicare) experience + Experience in regulatory regulations and monitoring… more
- Prime Therapeutics (Lansing, MI)
- …Management organization, or within a highly regulated industry, including experience with Medicare, Medicaid , and the Affordable Care Act (ACA) + Must be eligible to ... in related area of study, such as Juris Doctor + Medicare Part D, Medicaid , and/or Affordable Care Act knowledge and experience **Physical Demands** + Ability to… more
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