- Marshfield Clinic (Iron Mountain, MI)
- …rural health clinics within the Health System. This individual will assist with Medicare and Medicaid Cost Report coordination, Wage Index, S10, DSH and other ... been or be excluded from participation in any federally funded program, including Medicare and Medicaid. This is a condition of employment. Employee must immediately… more
- Highmark Health (Lansing, MI)
- …share and risk share models and will be implemented for the Organization's Medicare Advantage, Medicaid, ACA, and commercial populations with the goal of maximizing ... interpretation, and outcomes strategic plan development. + 1 year experience with Medicare STARS, Medicaid HEDIS, risk revenue value streams, and population health… more
- Evolent (Lansing, MI)
- …in the MD review process to reflect appropriate utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission ... by any state or federal health care program, including Medicare or Medicaid, and is not identified as an...General Service Administration (GSA), or reprimanded or sanctioned by Medicare . . No history of disciplinary or legal action… more
- Evolent (Lansing, MI)
- …in the MD review process to reflect appropriate utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission ... by any state or federal health care program, including Medicare or Medicaid, and is not identified as an...General Service Administration (GSA), or reprimanded or sanctioned by Medicare . + No history of a major disciplinary or… more
- Humana (Lansing, MI)
- …efficiency. Ensure robust database security, backup, recovery, and regulatory compliance in alignment with Humana's standards. Monitor database performance, ... Terraform. Familiarity with cloud security, access management, and regulatory compliance best practices. Excellent communication and documentation skills. Is eager… more
- Hospice of Michigan (Clinton Township, MI)
- …record (EHR), and coordinating with internal and external stakeholders to maintain compliance with hospice regulatory standards. The assistant serves as a vital link ... the EHR and communication platforms to ensure timely task resolution and compliance with documentation standards. + Monitors necessary reports to meet regulatory… more
- Humana (Lansing, MI)
- …through collaboration with diverse stakeholders across the enterprise, including legal, compliance , education, and IT. In this role, you will contribute to ... the enterprise, including model risk assessments, fairness evaluations, and compliance with ethical and regulatory standards. Champion transparency, accountability,… more
- Highmark Health (Lansing, MI)
- …with coding principles and guidelines. Promotes cooperation with CDMP and compliance programs to improve documentation which supports compliant coding. Interacts ... system entities in response to external coding audits conducted by the Medicare Administrative Contractor, the RAC, MIC, ZPIC, etc. Determine appeal action, prepare… more
- Humana (Lansing, MI)
- …for overseeing large-scale print production operations to ensure regulatory compliance , service level adherence, and operational efficiency. This position manages ... distribution of Enterprise outbound mail correspondence, ensuring accuracy, timeliness, and compliance + Collaborate with internal teams and external vendors to… more
- Humana (Lansing, MI)
- …renewal strategies aligned with Humana's technology roadmap, budget, and compliance requirements. + Establish governance frameworks for software renewals, including ... renewals. + Negotiate with suppliers to secure favorable terms, pricing, and compliance . + Maintain a centralized renewal calendar and proactively manage upcoming… more