• Field Access Manager - Central California…

    Merck (Lansing, MI)
    …information to HCP offices on how the products are covered under the benefit design (Commercial, Medicare , Medicaid) * Answer questions about coverage, including ... **Job Description** Field Access Manager The Field Access Manager (FAM)...compliance with healthcare regulations. The FAM role is a remote /field-based role that proactively provides approved education to defined… more
    Merck (11/27/25)
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  • RN UM Clinical Appeals Nurse Remote

    Molina Healthcare (MI)
    …highly preferred Work hours: Monday- Friday 8:00am - 5:00pm Central time Remote position **Essential Job Duties** * Performs clinical/medical reviews of previously ... Procedure Coding (HCPC). * Experience demonstrating knowledge of Centers for Medicare and Medicaid Services (CMS) guidelines, MCG, InterQual or other medically… more
    Molina Healthcare (11/14/25)
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  • LVN Delegation Oversight Nurse Remote

    Molina Healthcare (MI)
    …compliance with the National Committee for Quality Assurance (NCQA), Centers for Medicare and Medicaid Services (CMS), state Medicaid entity requirements and all ... is highly preferred. Work hours: Monday - Friday 8:00am - 4:00pm Remote position **Essential Job Duties** + Coordinates, conducts and documents pre-delegation and… more
    Molina Healthcare (11/13/25)
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  • Senior Field Reimbursement Manager - North…

    Danaher Corporation (Detroit, MI)
    …which makes everything possible. The Senior Field Reimbursement Manager (US REMOTE ) position is a provider ... we believe in designing a better, more sustainable workforce. We recognize the benefits of flexible, remote working arrangements for eligible roles and are… more
    Danaher Corporation (10/15/25)
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  • Specialist, Quality Interventions/QI Compliance…

    Molina Healthcare (MI)
    …activities and results to identify opportunities for improvement. + Surfaces to Manager and Director any gaps in processes that may require remediation. + ... Health or Healthcare. **Preferred Experience** 1 year of experience in Medicare and in Medicaid. **Preferred License, Certification, Association** + Certified… more
    Molina Healthcare (11/07/25)
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  • Physician Manager 20 - Medical Director

    State of Michigan (MI)
    Physician Manager 20 - Medical Director Print (https://www.governmentjobs.com/careers/michigan/jobs/newprint/4848644) Apply  Physician Manager 20 - Medical ... Date Continuous Bargaining Unit NON-EXCLUSIVE REPRESENTED EMPLOYEE (NERE) + Description + Benefits + Questions Job Description To learn more about a career at… more
    State of Michigan (10/01/25)
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  • LMSW/LCSW or LPC Behavioral Health Care…

    Humana (Lansing, MI)
    …assigned area in Wayne or Macomb county, to conduct in home visits with Medicare /Medicaid members.** **Must reside in Michigan with the ability to drive to Wayne or ... Macomb Counties.** The LMSW Behavioral Health Field Care Manager will serve as the primary liaison between Prepaid...to work effectively in a hybrid team setting of remote /in field. 10-15% travel** + Minimum 2 years in… more
    Humana (11/05/25)
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  • Case Manager Registered Nurse - Field…

    CVS Health (Royal Oak, MI)
    …models. You can have life-changing impact on our members who are enrolled in Medicare and Medicaid and present with a wide range of complex health and social ... review to conduct an evaluation of member's needs and benefits . + Applies clinical judgment to incorporate strategies designed...and health needs based on key questions and conversation. ** Remote Work Expectations** + This is a remote… more
    CVS Health (11/24/25)
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  • RN Clinical Manager

    CenterWell (Grand Rapids, MI)
    …one of the largest providers of home health services, and fourth largest pharmacy benefit manager , CenterWell is focused on whole-person health by addressing the ... Location** : Grand Rapids, MI **This is not a remote or work-from-home position. This position requires you to...our** **Grand Rapids, MI** **branch location.** The **RN Clinical Manager ** coordinates and oversees all direct care patient services… more
    CenterWell (10/31/25)
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  • RN Clinical Manager

    CenterWell (Portage, MI)
    …one of the largest providers of home health services, and fourth largest pharmacy benefit manager , CenterWell is focused on whole-person health by addressing the ... **Branch Location** : Portage, MI **This is not a remote or work-from-home position. This position requires you to...at our Portage, MI branch location.** The **RN Clinical Manager ** coordinates and oversees all direct care patient services… more
    CenterWell (09/06/25)
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