• Coding Data Quality Auditor

    CVS Health (Lansing, MI)
    …the ICD-10 codes that are submitted to the Centers for Medicare and Medicaid Services (CMS) for the purpose of risk adjustment processes are appropriate, accurate, ... coding, and/or auditing. + Experience with Medicare and/or Commercial and/or Medicaid Risk Adjustment process and Hierarchical Condition Categories CRC (HCC)CPMA… more
    CVS Health (10/16/25)
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  • Senior Quality Assurance, Professional

    Humana (Lansing, MI)
    …+ Bachelor of Science in Nursing (BSN) + Researching Medicare and Medicaid regulatory requirements + Working in an audit-based or compliance oversight role, ... 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 (10/16/25)
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  • Senior Field Reimbursement Manager - North East

    Danaher Corporation (Detroit, MI)
    …Communicate regional and local coverage and reimbursement issues for Medicare, Medicaid and Commercial payers through internal meetings, payer research, and customer ... (preferred) + Demonstrated knowledge of all payer segments (eg Commercial, Medicare, Medicaid ) + Demonstrated and presentation skills Travel, Motor Vehicle Record &… more
    Danaher Corporation (10/15/25)
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  • Senior Analyst, Business Consultant (Remote)

    CVS Health (Lansing, MI)
    …planning and execution of business unit strategic plans related to Medicaid provider directory standardization and optimization. **Key Responsibilities** + Managing ... create charts, compare and handle large data sets). + Strong knowledge of Medicaid products and understanding of provider data / directory products. + Excellent… more
    CVS Health (10/13/25)
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  • QA External LTSS Oversight Professional

    Humana (Lansing, MI)
    …in the state of Michigan: LPN, RN, LSW, LISW. + Previous Medicare/ Medicaid , MDHHS, CMS, and NCQA experience. **Additional Information** . **Workstyle** : This ... 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 (10/10/25)
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  • Coordinator, Financial Counseling

    Cardinal Health (Lansing, MI)
    …for patient responsibility + Applying for financial assistance. + Applying for Medicaid /Medi-Cal. + Coordinate with early out collections partner for payment plan ... claim processing and denial management preferred. + Familiarity with Medicare, Medicaid , commercial insurance plans, and managed care preferred. + Proficiency in… more
    Cardinal Health (10/10/25)
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  • Encounter Data Management Professional

    Humana (Lansing, MI)
    …or adjacent sectors **Preferred Qualifications** + Comprehensive knowledge of Medicare, Medicaid , and DSNP encounter processes and policies. + Familiarity with EDI ... 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 (10/08/25)
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  • Senior Accreditation Professional

    Humana (Lansing, MI)
    …Universes. + Registered Nurse or Behavioral Health professional. + Managed care, Medicaid health plan experience. + Advanced degree in a healthcare-related field. ... 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 (10/08/25)
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  • Community Health Worker (Home Visiting - Wayne…

    Corewell Health (Southfield, MI)
    Job Summary Priority Health, Medicaid Care Management team, is seeking a Community Health Worker specifically for Wayne County, Michigan. This is a home and ... Service Center - 26901 Beaumont Blvd Department Name PH - Care Management - Medicaid Employment Type Full time Shift Day (United States of America) Weekly Scheduled… more
    Corewell Health (10/06/25)
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  • Director, Provider Contracts (Must reside…

    Molina Healthcare (MI)
    …Committees. * Manages and reports network adequacy for Medicare, Marketplace, and Medicaid services. * In conjunction with direct management and senior leadership, ... of, various managed healthcare provider compensation and VBP methodologies, primarily across Medicaid and Medicare lines of business, including but not limited to;… more
    Molina Healthcare (10/05/25)
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