- Humana (Lansing, MI)
- …support across a broad range of actuarial, managerial, and business needs for Medicaid -specific product lines. The Lead Actuary will serve as a project manager ... review and documentation. The Lead Actuary will be responsible for Medicaid -specific functions such as capitation rate review, drafting rate advocacy communications,… more
- Molina Healthcare (MI)
- **JOB DESCRIPTION** **Job Summary** The Manager , Medical Economics provides support and consultation to the Health Plan and Finance team through analyzing key ... performance is achieving desired results + Keep abreast of Medicaid and Medicare reforms and their impact on Molina...- 5 years supervisory experience + Demonstrated understanding of Medicaid and Medicare programs or other healthcare plans +… more
- Humana (Lansing, MI)
- …practices, and design clinical solutions for members who have Medicare and Medicaid . The Lead Product Manager partners across various multi-disciplinary teams ... dual members - members that qualify for both Medicare and Medicaid . The Lead Product Manager sits in the center of strategy, design, technology, clinical, and… more
- Humana (Lansing, MI)
- …a part of our caring community and help us put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business Intelligence ... Pricer Business and System Support team responsible for administering complex Medicaid provider reimbursement methodologies. The associate will support existing … more
- CenterWell (Lansing, MI)
- …a part of our caring community and help us put health first** The Medicaid Drug Strategy Pharmacist Lead requires a broad understanding of pharmacy, managed care, ... drug strategies to mitigate cost trend and improve health outcomes. The Medicaid Drug Strategy Pharmacist Lead work assignments involve moderately complex to complex… more
- Humana (Lansing, MI)
- …an assigned area in Wayne or Macomb county, to conduct in home visits with Medicare/ Medicaid members.** The Field Care Manager Nurse 2 employs a variety of ... and help us put health first** The Field Care Manager Nurse 2 assesses and evaluates member's needs and...with health promotion, coaching and wellness + Experience with Medicaid Long Term Care + Previous managed care experience… more
- Prime Therapeutics (Lansing, MI)
- …we make. **Job Posting Title** IT Business Systems Analyst Sr - Medicaid Pharmacy Implementations - Remote **Job Description** The IT Business Systems Analyst ... resource needs; collaborate with Business Systems Analyst Resource Lead or Resource Manager to determine work assignments within project + Educate and advance… more
- Molina Healthcare (Ann Arbor, MI)
- …monitor, and troubleshoot Hadoop-based infrastructure using tools such as Cloudera Manager , Ambari, and Zookeeper. * Enforce data quality, security, and compliance ... in deploying and monitoring big data infrastructure with Ambari, Cloudera Manager , and Zookeeper. * Solid understanding of data warehousing, data validation,… more
- Prime Therapeutics (Lansing, MI)
- …passion and drives every decision we make. **Job Posting Title** Manager Rebate Pharmacy Operations **Job Description Summary** This position provides administrative ... teamwork across all internal departments, as well as with Medicaid Clients, and an in-depth understanding of all rebate...state laws and standards of practice which govern the Medicaid Drug Rebate Program. + Ensures compliance with each… more
- Molina Healthcare (Grand Rapids, MI)
- **Job Description** **Job Summary** The Health Plan Operations, Payment Integrity Program Manager is an individual contributor role designed for a highly capable ... years of experience as a Business Analyst or Program Manager in a Managed Care Organization (MCO) or health...experience. + At least 3 years of Experience with Medicaid and/or Medicare. + Proven experience owning operational projects… more