- Prime Therapeutics (Lansing, MI)
- …It fuels our passion and drives every decision we make. **Job Posting Title** Account Manager Sr - NC Medicaid - Remote Raleigh, NC **Job Description** The ... Senior Account Manager is responsible for providing complex level support for...for providing complex level support for the North Carolina Medicaid business by driving communications, client-facing initiatives, and product… more
- Humana (Lansing, MI)
- …of our caring community and help us put health first** Humana is seeking a Manager , Quality Assurance (External LTSS Oversight Team Manager ) who will lead a team ... and assist with monitoring day-to-day operational activities with AAAs. The Manager , Quality Assurance works within specific guidelines and procedures; applies… more
- Molina Healthcare (Grand Rapids, MI)
- …of external vendors. + Focuses on process improvement, organizational change management, program management and other processes relative to the business. + Leads and ... product development. + Operational Process Improvement experience. + Project and program management experience + Healthcare experience. + Excellent presentation and… more
- CVS Health (Lansing, MI)
- …years of leadership experience + A minimum 3 years of experience in a Healthcare Program Integrity, Medicaid Special Investigation or Medicaid / Medicare / ... lost funds, and to comply with state regulations mandating fraud plans and reporting; Medicaid experience is preferred. Leads a team in the planning and execution of… more
- Henry Ford Health System (Troy, MI)
- The Program Manager - Population Health & Value-Based Payment has an important role in a high-profile group tasked with implementing system-wide improvements ... to the Director, Risk Adjustment and Value-Based Payment, the Program Manager is responsible for complex ...departmental staff and multi-disciplinary teams. + Knowledge of Medicare, Medicaid , Blue Cross and other third-party payers billing and… more
- Molina Healthcare (Belleville, MI)
- …RN license in the state of MI. This position will support our MMP ( Medicaid Medicare Population) that is part of the Waiver Team. This position will have ... a case load and manage members enrolled in this program . We are looking for Registered Nurses who have...resources and recommendations to peers as needed. * Care manager RNs may be assigned complex member cases and… more
- Molina Healthcare (Warren, MI)
- …leadership to healthcare services function - providing support for project/ program /process design, execution, evaluation and support, and ensuring compliance with ... the design process to completion. + Provides ongoing communication related to program goals, evaluation and support to ensure compliance with standardized protocols… more
- Humana (Detroit, 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...This role is a part of Humana's Driver Safety program and therefore requires and individual to have a… more
- Molina Healthcare (MI)
- …work of external vendors. Assigns, directs and monitors system analysis and program staff. These positions' primary focus is project/ program management. **Job ... Provide credentialing/recredentialing details for monthly/quarterly/semi-annual turnaround time reports to Medicaid agencies as required + Active collaborator with people… more
- Molina Healthcare (Grand Rapids, MI)
- …work of external vendors. Assigns, directs and monitors system analysis and program staff. These positions' primary focus is project/ program management. **Job ... + Writes narrative reports interpreting regulatory specifications and documenting program outcomes. + Maintains and updates policies, procedures, and… more
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