- Molina Healthcare (Detroit, MI)
- …pharmacies and technicians - ensuring departmental and Centers for Medicare and Medicaid Services (CMS) standards are met. * Educates Molina members on the ... is current and up-to-date. * Effectively communicates general Medicare and Medicaid plan benefits to existing pharmacy members. * Interacts with appropriate… more
- Henry Ford Health System (Detroit, MI)
- …Verification, Self-Pay conversions strategies including but not limited to Medicaid Eligibility Application Services, Inpatient and Outpatient Registration Services, ... to insurances for but not limited to, Motor Vehicle accidents, Workmen Compensation, Medicaid , Group Health Plans, BCBS and Medicare. Ability to create, analyze and… more
- Humana (Lansing, MI)
- …Previous experience with pharmacy benefits management + Previous Commercial, Medicare and/or Medicaid experience + 3 or more years clinical experience in managed ... are leading to a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at large. **Equal… more
- Henry Ford Health System (Troy, MI)
- …Government programs compliance oversight and regulations may be specific to Medicare, Medicaid , Office of Personnel Management (OPM) the Affordable Care Act (ACA) or ... plan compliance. + Experience with ACA, Medicare Advantage Part D and Medicaid compliance regulations. + Certification or designation in Health care compliance or… more
- Molina Healthcare (Ann Arbor, MI)
- …and unrestricted State (TX) Medical License, free of sanctions from Medicaid or Medicare. **Preferred Experience** * Peer Review, medical policy/procedure ... development, provider contracting experience. * Experience with NCQA, HEDIS, Medicaid , Medicare and Pharmacy benefit management, Group/IPA practice, capitation, HMO… more
- University of Michigan (Ann Arbor, MI)
- …requires management of very large data sets including Medicare, Medicaid , MarketScan, Truven, regional insurance claims, and patient registries. **Responsibilities ... major research projects using large administrative datasets such as Medicare, Medicaid , and commercial insurance is preferred + Experience with database management… more
- Humana (Lansing, MI)
- …in interviews and working sessions with leaders within Medicare and Medicaid and across the broader organization + Conducting industry, market, competitor, ... 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)
- …Guidance on following and reviewing home health, SNF, DME, dual Medicare/ Medicaid and Waiver requests. The Medical Director provides medical interpretation and ... leading to a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at large. **Equal… more
- Molina Healthcare (Detroit, MI)
- …and requirements established by the Centers for Medicare and Medicaid **KNOWLEDGE/SKILLS/ABILITIES** + Responsible for the comprehensive research and resolution ... coordination of benefits, subrogation, and eligibility criteria. + Familiarity with Medicaid and Medicare claims denials and appeals processing, and knowledge of… more
- Humana (Lansing, MI)
- …insurance industry experience working in Finance/Accounting + Experience with Wisconsin Medicaid programs **Additional Information** Interview Format As part of our ... are leading to a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at large. **Equal… more