- Molina Healthcare (MI)
- …existing clinical quality member intervention initiatives including all lines of business (Medicare, Marketplace, Medicaid ). Executes health plan's member and ... **Job Description** **Job Summary** The Sr Specialist , Member & Community Interventions oversees and implements...programs as assigned + This position may require same-day out-of- office travel 0 - 80% of the time, depending… more
- Highmark Health (Lansing, MI)
- …the Organization's value-based reimbursement programs for both the commercial and government business with a focus on enterprise goals including but not limited to ... Government Markets (STARS, ACA, CHIP, Medicaid DE) and Enterprise Quality, Safety, and Values (Health...25% **PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS** **Position Type** Office - or Remote-based Teaches / trains others Occasionally Travel… more
- Prime Therapeutics (Lansing, MI)
- …every decision we make. **Job Posting Title** Medication Therapy Management Specialist **Job Description** The Medication Therapy Management (MTM) Service ... Specialist is responsible for receiving inbound and making outbound...outbound calls to qualified members across all lines of business to review the benefits of the MTM program.… more
- Trinity Health (Ann Arbor, MI)
- …Communicates frequently with patients/family members/guarantors, and physicians or their office staff in the deployment of key activities. Interviews patients ... combination of education and experience. Associate degree in Accounting or Business Administration highly desired. Experience: Minimum of one year experience in… more
- Trinity Health (Livonia, MI)
- …Health operations as identified by Department of Health & Human Services (DHHS) - Office of Inspector General (OIG), Centers for Medicare & Medicaid Services ... (ICP). Provides assistance with monitoring changes in laws, regulations and business ethics practices impacting corporate compliance programs. Assists management in… more
- Trinity Health (Howell, MI)
- …Communicates frequently with patients/family members/guarantors, and physicians or their office staff in the deployment of key activities. Interviews patients ... combination of education and experience. Associate degree in Accounting or Business Administration highly desired. **Experience:** Minimum of one year experience in… more
- Novo Nordisk (Ann Arbor, MI)
- …part of the team, you will have frontline exposure to our portfolio vision, business strategies, and critical market insights that drive our business forward. ... Novo Nordisk's portfolio of products to HCPs and other office staff. Relationships Externally, the DCS I maintains relationships...partners. Internally, the DCS I reports to the District Business Manager of the specific sales territory. The DCS… more
- Prime Therapeutics (Lansing, MI)
- … Medicaid Drug Rebate Program. + Ability to effectively communicate across business lines. + Working knowledge of Microsoft Office Suite, specifically Excel. ... management. Enforces teamwork across all internal departments, as well as with Medicaid Clients, and an in-depth understanding of all rebate programs, trends, and… more
- Humana (Lansing, MI)
- …accountable care organization that participates in the Centers for Medicare and Medicaid Services' Medicare Shared Savings Program (MSSP), plus other commercial and ... The position emphasizes skills related to population health management, healthcare business planning, and leadership. Based on interests, the program may include… more
- Trinity Health (Livonia, MI)
- …modifiers. Utilizes coding guidelines established by: + The Centers for Medicare/ Medicaid Services (CMS) ICD-CM Official Coding Guidelines for Coding and Reporting, ... knowledge of Medical Necessity review guidelines for commercial, Medicare and Medicaid insurance products, including but not limited to Local Coverage Determination,… more