• Medicare Compliance Consultant

    CVS Health (MI)
    …And we do it all with heart, each and every day. **Position Summary** The ** Medicare Compliance Consultant** is a compliance role that supports the ... partnership with - and under the direction of - the health plan, Medicare Compliance Officer, and other team members, this position will help develop and… more
    CVS Health (09/18/25)
    - Related Jobs

  • Lead Director, Product Mgt & Development…

    CVS Health (MI)
    …highly regulated function, this role will also oversee delegated PBM functions, cross Medicare Pharmacy Organizational Compliance with CMS regulations as well as ... implementation and milestone tracking for business plans as Part of the Medicare benefit and product cycle. Directs the strategic development and implementation of… more
    CVS Health (09/24/25)
    - Related Jobs

  • Supervisor Medicare LTSS Operations

    AmeriHealth Caritas (Detroit, MI)
    …the existing organizational processes and procedures to support the quality and compliance of operations for Medicare LTSS Care Coordination, including ... Discover more about us at www.amerihealthcaritas.com. **Responsibilities:** The Supervisor, Medicare LTSS Operations is responsible for ensuring and improving the… more
    AmeriHealth Caritas (10/04/25)
    - Related Jobs

  • Director, Regulatory Operations

    Centene Corporation (Lansing, MI)
    …products/services. + Oversee, administer, and implement various aspects of the Medicare Compliance program, including HPMS communication/regulation + Ability to ... track laws and regulations, contract documentations, amendments, and various compliance measures + Ensure all Medicare products...and various compliance measures + Ensure all Medicare products and services are being tested for … more
    Centene Corporation (10/03/25)
    - Related Jobs

  • SVP Chief Compliance and Privacy Officer

    Corewell Health (Grand Rapids, MI)
    …direction to the system clinical compliance team to ensure effective compliance with Medicare Conditions of Participation as evaluated by deeming agencies ... Job Summary - Senior Vice President, Chief Compliance and Privacy Officer Corewell Health is seeking...solution-oriented leader to serve as Senior Vice President, Chief Compliance and Privacy Officer . This role l ead… more
    Corewell Health (08/16/25)
    - Related Jobs

  • Business Intelligence Lead Clinical Care…

    Humana (Lansing, MI)
    …analytics. + Maintain project documentation, data quality checks, and ensure compliance with Medicare /Medicaid program reporting standards. **Use your skills ... familiarity with care management metrics, including productivity, quality, regulatory compliance , and program effectiveness for Medicare /Medicaid + Strong… more
    Humana (09/30/25)
    - Related Jobs

  • RN Administrator Home Health $10K Sign On

    Elara Caring (Ludington, MI)
    …staffing levels at branch locations to meet patient needs. + Ensures compliance of current Medicare , Medicaid, and third-party reimbursement regulations and ... all documentation is accurate, complete, timely and adheres to Medicare guidelines. + Assures compliance with the requirements of state licensure, Medicare … more
    Elara Caring (09/12/25)
    - Related Jobs

  • Auto Claims Examiner, Bodily Injury

    Sedgwick (Grand Rapids, MI)
    …and laws + Knowledge of medical terminology for claim evaluation and Medicare compliance + Knowledge of appropriate application for deductibles, sub-limits, ... SIR's, carrier and large deductible programs. + Strong oral and written communication, including presentation skills + PC literate, including Microsoft Office products + Strong organizational skills + Strong interpersonal skills + Good negotiation skills +… more
    Sedgwick (09/19/25)
    - Related Jobs

  • Senior Compliance Analyst (Risk Assessment…

    Prime Therapeutics (Lansing, MI)
    …analytical skills **Preferred Qualifications** + PBM/health care experience related to Medicare , Medicaid, Commercial, HIM + Certified Compliance and Ethics ... passion and drives every decision we make. **Job Posting Title** Senior Compliance Analyst (Risk Assessment and Oversight) - Remote **Job Description** The Senior… more
    Prime Therapeutics (09/17/25)
    - Related Jobs

  • Director, Medicare Segment Optimization…

    Molina Healthcare (Warren, MI)
    …Molina Healthcare's overall mission, core values, and strategic plan and in compliance with all relevant federal, state, and local regulatory requirements. **Job ... markets, including D-SNP market performance management. + Function as Medicare subject matter expert and point of contact for...Monitor and support sales and retention efforts. + Monitor compliance and regulatory risks. + Contribute to and present… more
    Molina Healthcare (09/07/25)
    - Related Jobs