- Molina Healthcare (Warren, MI)
- …risk adjustment projects for all lines of business (Medicare, Medicaid and Marketplace) **Knowledge/Skills/Abilities** * Collaborates with senior executives, Vice ... least 5 years in health plan risk adjustment. * Minimum 4 years Medicaid / Medicare/Marketplace experience. * Minimum 5 years people management experience * Minimum 5… more
- Cognizant (Lansing, MI)
- …decisions in collaboration with business teams. + Ensure compliance with Medicaid and Medicare program requirements. **Work model:** We strive to provide ... skills for claim pend issues and defect remediation. + Familiarity with Medicaid and Medicare programs. **These will help you stand out:** + Experience… more
- CVS Health (Lansing, MI)
- …submit ICD codes that are submitted to the Centers for Medicare and Medicaid Services (CMS) for the purpose of risk adjustment processes are appropriate, accurate, ... (ICD) codes required. + Experience with Medicare and/or Commercial and/or Medicaid Risk Adjustment process and Hierarchical Condition Categories (HCC) preferred.… more
- McLaren Health Care (Flint, MI)
- …health plan, working with the State of Indiana and Centers for Medicare and Medicaid Services to bring you the Hoosier Healthwise and Healthy Indiana Plan health ... communication, and problem-solving skills, along with knowledge of healthcare systems and Medicaid policies specific to Michigan. **This is a hybrid position with… more
- Humana (Lansing, MI)
- …Ability to think strategically and execute tactically. **Preferred Qualifications** + Medicaid or Medicare experience **Additional Information** To ensure Home or ... are leading to a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at large. **Equal… more
- Humana (Lansing, MI)
- …the collection of required compliance documentation, and assisting with new Medicaid contract implementations. **Use your skills to make an impact** **Required ... are leading to a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at large. **Equal… more
- Humana (Lansing, MI)
- …processes; flexibility in job focus + Understanding of Centers for Medicare & Medicaid Services (CMS) guidelines Travel: While this is a remote position, occasional ... are leading to a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at large. **Equal… more
- CVS Health (Lansing, MI)
- …2 and up to 4 market segments for any particular client (Medicare, Medicaid , Exchange, or Commercial). The Health Plan Clinical Advisor is responsible for ... within a health plan. + Experience in all market segments (Medicare, Medicaid , Exchange and Commercial) + Expertise in Utilization Management, Formulary Management… more
- Humana (Lansing, MI)
- …an impact** **Required Qualifications** + Experience with Medicare Advantage and/or Medicaid + Comprehensive knowledge of Microsoft Office applications: Word, Excel, ... are leading to a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at large. **Equal… more
- Humana (Lansing, MI)
- …interpreting claims within a managed care/health care environment + Familiarity with Medicaid contracts, claims, and/or process flows + Skilled in data and/or ... are leading to a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at large. **Equal… more