- Humana (Lansing, MI)
- …performing application security-focused penetration tests. This role helps maintain PCI-DSS compliance and supports the team's success by: * Contributing technical ... to both technical and executive stakeholders + Knowledge of regulatory compliance frameworks, particularly PCI DSS penetration testing requirements and methodologies… more
- Molina Healthcare (MI)
- …functional areas in alignment with regulatory requirements - ensuring quality compliance and desired member outcomes. Contributes to overarching strategy to provide ... management, care management, member assessment, and/or other teams - monitoring for compliance with National Committee for Quality Assurance (NCQA), Centers for … more
- Integra Partners (Troy, MI)
- …timely issue resolution. In this role, you will ensure work is in compliance with all legal, regulatory, and internal Integra policies and procedures, including ... HIPAA compliance . If you have previous medical billing or claims...objectives + Stay informed on product information, changes in Medicare /State/Contract funding procedures, and updates in policies and procedures… more
- Cardinal Health (Lansing, MI)
- …initiatives to optimize cash flow, reduce aging accounts, and ensure compliance with payer and regulatory requirements. **Responsibilities:** + Lead and manage ... for complex or high-dollar claims. + Stay current with payer policy changes, compliance regulations, and industry best practices. + Analyze trends in denials and… more
- Henry Ford Health System (Detroit, MI)
- …that plays a central role in ensuring accurate net revenue reporting, compliance with complex payer regulations, and optimization of financial performance. Building ... net revenue impacts and forecasts to inform systemwide financial planning. Regulatory Compliance & Audit Oversight + Plan and coordinate third-party audits and… more
- Henry Ford Health System (Southfield, MI)
- …includes oversight of care delivery, health plan operations, financial management, regulatory compliance , and culture. The CEO must be a strong servant-leader with ... delivery of safe, coordinated, and participant-centered care across all sites in compliance with CMS and state regulations. + Provide strategic oversight of health… more
- Humana (Lansing, MI)
- …pillars, including continuous integration (CI), continuous delivery (CD), quality, security, compliance , metrics, and reporting. + Ensure compliance with ... to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
- ChenMed (Detroit, MI)
- …mission-driven, primary care organization, is currently one of the most successful full-risk Medicare Advantage providers in the nation and has a vision to be ... work closely with the applicable managers and medical directors to ensure compliance with guidelines along with participating in risk and quality management… more
- Aveanna Healthcare (Dearborn, MI)
- …Responsible for the delivery and coordination of quality patient care in compliance with physician orders. * Continuously observes and assesses patient condition and ... CPR certification * Demonstrated proficiency in clinical assessments, documentation and compliance with nursing care and policies and procedures Additional state… more
- Humana (Detroit, MI)
- …communicate important policy or programmatic updates to providers. + Ensure compliance with Michigan managed care contractual requirements for provider relations, ... to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more