- CenterWell (Lansing, MI)
- …of our caring community and help us put health first** The Lead - Medicaid Customer Success oversees strategy and operations for multiple Medicaid markets. This ... contracts, as well as to identify opportunities and implement program improvements to enhance our member and customer experience....affairs teams, sales teams define overall strategy for each Medicaid state + Work with market partners to perform… 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
- Prime Therapeutics (Lansing, MI)
- …compliance with federal laws, state laws and standards of practice which govern the Medicaid Drug Rebate Program . + Ensures compliance with each State ... and drives every decision we make. **Job Posting Title** Manager Rebate Pharmacy Operations **Job Description Summary** This position...and regulations as they pertain to rebate processing and Medicaid Drug Rebate Program . + Ability to… more
- Molina Healthcare (Ann Arbor, MI)
- …of external vendors. + Focuses on process improvement, organizational change management, program management and other processes relative to the business. + Serves as ... years supervisory/management experience in a managed healthcare environment. + Medicaid /Medicare Population experience with increasing responsibility. + 3+ years of… more
- Molina Healthcare (Detroit, 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...**Preferred License, Certification, Association** Active and unrestricted Certified Case Manager (CCM) To all current Molina employees: If you… 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...This role is a part of Humana's Driver Safety program and therefore requires and individual to have a… more
- Corewell Health (Grand Rapids, MI)
- Job Summary - Manager , Payment Integrity Seeking a strategic and results-driven leader to join Priority Health as a Manager , Payment Integrity. This role is ... alignment. Responsible for management of all aspects of the Payment Integrity Program with specific expertise in healthcare payment and reimbursement. The Payment… more
- Humana (Lansing, MI)
- …a part of our caring community and help us put health first** The Manager , Care Management leads teams of nurses and behavior health professionals responsible for ... care management. The Manager , Care Management works within specific guidelines and procedures;...+ This role is part of Humana's Driver Safety program and therefore requires an individual to have a… more
- Henry Ford Health System (Troy, MI)
- General Summary: The Clinical Manager , Medical Appeals supports appeals team members to plan, direct, evaluate, coordinate, and manage the activities associated with ... provider appeals, for all product lines (HMO, AHL, and Medicare Advantage (MA), Medicaid , and Duals) in accordance with internal HAP policies. Coordinate with the… more