- Elara Caring (Rochester Hills, MI)
- …years' experience In a Health Care setting + Knowledge of Medicare and Medicaid , home health care benefits, policies and procedures + Excellent computer and ... communication skills, with ability to work in fast-paced environment + Reliable transportation to perform job responsibilities You will report to the Branch Director, Alternative Branch Director, or Regional Branch Director. _This is not a comprehensive list… more
- CVS Health (Lansing, MI)
- …role is a telephonic clinical case management position working with our Medicaid population. Use of Motivational Interviewing skills, members are outreached and ... engaged in interventions that optimize member participation in case management programs. BH CM utilizes advanced clinical judgment and critical thinking skills to facilitate appropriate member physical health and behavioral healthcare through assessment and… more
- CVS Health (Lansing, MI)
- …Lean Six Sigma (Green/Black Belt) - Tableau Dashboards/Analytics -Medicare / Medicaid experience -Experience with HEDIS Metrics, CAHPS Member Satisfaction Surveys, ... NCQA Accreditation, Compliance Audits and/or MI State Reporting / Compliance **Education** . Bachelor's degree or equivalent managed care experience **Anticipated Weekly Hours** 40 **Time Type** Full time **Pay Range** The typical pay range for this role is:… more
- Munson Healthcare (Manistee, MI)
- …EOC, EM and Life Safety standards, The Centers for Medicare and Medicaid Services (CMS) requirements, Michigan Occupational Safety and Health Administration (MIOSHA) ... regulations/laws, National Fire Protection Agency (NFPA), and other related regulatory agency standards. Ready to Make a Difference? Your Responsibilities Include: Carries out responsibilities of the Safety Officer for three hospitals. Serve as the leader and… more
- Molina Healthcare (Ann Arbor, MI)
- …and processing. This role will focus on identifying, reviewing, and validating Medicaid secondary payments to ensure alignment with internal configuration rules and ... adjudication, QNXT system navigation, and strong analytical acumen. Experience in Medicaid managed care is required, and a background in payment integrity-either… more
- Molina Healthcare (Sterling Heights, MI)
- …Assists and executes tasks and projects to ensure Centers for Medicare & Medicaid Services (CMS) and State regulatory requirements are met for Pre-pay Edits, ... + At least 6 years of experience as a Business Analyst or Program Manager in a Managed Care Organization (MCO) or health plan setting, including experience in… more
- Henry Ford Health System (Troy, MI)
- GENERAL SUMMARY: Reporting to the Manager , Revenue Integrity, the Revenue Integrity Specialist identifies revenue opportunities and works collaboratively with ... by upholding compliance standards. Under limited supervision from the Manager , Revenue Integrity or other more senior Revenue Integrity...issues at a high level. + Knowledge of Medicare, Medicaid , Medicaid OPPS reimbursement, and other third-… more
- Corewell Health (Dearborn, MI)
- …up to a $1500.00 starting bonus! A Wing is a 58 bed Medicare/ Medicaid unit that has residents with multiple clinical issues including CHF, dehydration, cellulites, ... and personal satisfaction. B Wing is a 40 bed Medicare/ Medicaid /Dementia unit. We provide care to residents with a...direct patient care under the direction of the Unit Manager or Licensed Nurse, consistent with policies and procedures… 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
- R1 RCM (Detroit, MI)
- …to meet their financial obligations. Work with Case Management, Clinical Staff, Medicaid Vendor, and Family Independence Agency to assist patients and families in ... completing assistance program applications and determine eligibility and coverage. Notify manager , physician and servicing department of possible delay of service… more