- 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 ... MCO Oversight Analyst - MDHHS OIG Salary $2,008.00 - $ 3 ,146.40 Biweekly Location Lansing, MI Job Type Permanent Full... program integrity requirements of the Medicaid Managed… 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
- Molina Healthcare (Grand Rapids, MI)
- …experience in healthcare claims review and/or member appeals and grievance processing/resolution, including 3 years in a manager role. * Experience with Medicare ... the standards and requirements established by the Centers for Medicare and Medicaid . This position will provide direct support to the implementation efforts specific… more
- Henry Ford Health System (Troy, MI)
- Reporting to the CDM Manager , the CDM Analyst is responsible for supporting and maintaining the Charge Description Master (CDM), including being responsible for the ... HELIOS required change control processes for all updates/changes needed. 3 . Participates in CAB call for Service Now Tickets...and updates fee schedule rates in POC for CDM Manager 's review. 11.Provides quality control check and audits that… more
- Marshfield Clinic (Iron Mountain, MI)
- …any time have been or be excluded from participation in any federally funded program , including Medicare and Medicaid . This is a condition of employment. ... nursing experience, or recent completion of a nursing education program . **CERTIFICATIONS/LICENSES** _The following licensure(s), certification(s), registration(s), etc., are… more
- CenterWell (Lansing, MI)
- …CenterWell ACO and Medicare payment model programs via the Center for Medicare and Medicaid Services (CMS), such as ACO REACH, MSSP, and future models. Under general ... teams to manage all aspects of ACO operations including program administration, contract oversight, process, performance improvement, compliance, governance,… more
- Marshfield Clinic (Iron Mountain, MI)
- …any time have been or be excluded from participation in any federally funded program , including Medicare and Medicaid . This is a condition of employment. ... within 30 days of hire. Conscious sedation certification within 3 months of hire or transfer. ACLS and PALS...for our trauma systems. Works collaboratively with the ED Manager for the overall coordination of the clinical systems,… more
- Marshfield Clinic (Iron Mountain, MI)
- …any time have been or be excluded from participation in any federally funded program , including Medicare and Medicaid . This is a condition of employment. ... within 30 days of hire. Conscious sedation certification within 3 months of hire or transfer. ACLS and PALS...Employee must immediately notify his/her manager or the Health System's Compliance Officer if he/she… more