- Prime Therapeutics (Lansing, MI)
- …pharmacy networks composition to assess network adequacy, contracting gaps and compliance with regulations + Represent Network Management department in audits and ... Ensure all contractual obligations are in adherence with company policies, regulatory compliance and legal requirements and engage with Legal and Network Management… more
- Molina Healthcare (Warren, MI)
- …reviews and appeals. * Supports behavioral health committees for quality compliance . * Implements behavioral health specific clinical practice guidelines and medical ... review criteria. * Tracks all clinical programs for behavioral health quality compliance with National Committee for Quality Assurance (NCQA) and Centers for … more
- Humana (Lansing, MI)
- …clearly-especially around generative AI. Design for scalability, reliability, and compliance . + **MLOps & DevOps Collaboration** Work with engineering and ... 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
- Humana (Lansing, MI)
- …Experience in supplier diversity, ethical sourcing, environmental initiatives and regulatory compliance + Advance proficiency in Microsoft Office Suite (Word, Excel, ... 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
- Deloitte (Midland, MI)
- …for other Health Plan Actuarial liabilities for Premium Deficiency Reserves, Medicare Risk Adjustment, MLR (Minimum Loss Ratio) Calculations, Provider Liabilities / ... Actuarial reviews of all booked Health Plan Actuarial liabilities for compliance with applicable regulatory requirements. + Coordination of planning, managing… more
- Fresenius Medical Center (Detroit, MI)
- …nurse in accordance with organization policies, procedures, and training and in compliance with regulations set forth by the corporation, state, and federal ... business policies, procedures and systems incorporated into training, including compliance with ethical business practices + Maintain environmental integrity and… more
- Humana (Lansing, MI)
- …and consumption. + Stay apprised and understand Interoperability regulatory and compliance requirements from CMS distilling those into product technical requirements ... 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
- Humana (Lansing, MI)
- …Responsibilities** + Work closely with Retail and FMO partners to ensure program compliance + Build, execute and monitor 3 year business plan for retail program ... 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
- Prime Healthcare (Port Huron, MI)
- …Healthgrades Patient Safety Excellence Award, rated four stars by the Centers for Medicare & Medicaid Services and earned The Joint Commission's Gold Seal of ... Approval(R) for Hospital Accreditation by demonstrating continuous compliance with its performance standards. Learn more atwww.mylakehuron.com. As a member of Prime… more
- Fresenius Medical Center (Wyoming, MI)
- …vision core values and customer service philosophy. Adheres to the FMCNA Compliance Program including following all regulatory and FMS policy requirements. Functions ... licensed nurse in accordance with FMCNA policies procedures and training and in compliance with regulations set forth by the corporation state and federal agencies.… more