- Molina Healthcare (Benton Harbor, MI)
- …RN license in the state of MI. This position will support our MMP ( Medicaid Medicare Population) will be supporting DSNP. This position will have a case load ... and manage members enrolled in this program . We are looking for Registered Nurses who have...settings. Preferred License, Certification, Association Active, unrestricted Certified Case Manager (CCM) To all current Molina employees: If you… more
- State of Michigan (Lansing, MI)
- …and increasing program integrity and accountability. This position assists the manager of the Managed Care Oversight Unit to manage and ensure compliance with ... program integrity requirements of the Medicaid Managed Care Entities including, but not limited to Medicaid Health Plans (MHPs), Prepaid Inpatient Health… 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) ... Opportunities for career growth and development * Wellness offerings, employee assistance program , and exclusive employee discounts Ready to Begin Your Next Chapter?… more
- Molina Healthcare (Grand Rapids, MI)
- …outreach and coordination of services, including MTM services for Medicare and Medicaid eligible members as well as Medication Adherence Programs for STAR, HEDIS ... all CMS guidelines and reporting requirements for the MTM Program ; fulfills all required process and outcome measurements and...recommended changes to drug therapy were implemented. * Assists Manager or Director in the collection and tabulation of… more
- Molina Healthcare (MI)
- …intervention initiatives including all lines of business (Medicare, Marketplace, Medicaid ). Executes health plan's member and community quality focused interventions ... and programs in accordance with prescribed program standards, conducts data collection, monitors intervention activity including...to identify opportunities for improvement + Surfaces to the Manager and Director any gaps in processes that may… 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 (Watervliet, MI)
- …IRF-PAI tool including transmission of records to the Centers for Medicare and Medicaid Services (CMS) and other insurances as needed. Monitor and educate clinicians ... companies regarding authorizations and denials. Executes standard work regarding Medicaid appeals/denials, change requests, and all insurance authorizations. +… more
- Elevance Health (Dearborn, MI)
- …contracts for Medicare and partner with the Centers for Medicare and Medicaid Services to transform federal health programs. The **Medical Director** is responsible ... + Provides guidance for clinical operational aspects of a program . + Serves as a resource and consultant to...changes in healthcare. + Partner with The Center for Medicaid and Medicare Services (CMS) on inquiries and policy… more
- Corewell Health (Dearborn, MI)
- …up to a $750.00 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
- Molina Healthcare (Grand Rapids, MI)
- …the standards and requirements established by the Centers for Medicare and Medicaid . This position will provide direct support to the implementation efforts specific ... UM, Case Management, Claims, and other departments within Molina Medicare and Medicaid regarding A&G operations and dependencies. * Responsible for the A&G… more