- Prime Therapeutics (Lansing, MI)
- …our passion and drives every decision we make. **Job Posting Title** Sr. Compliance Analyst - Remote **Job Description** The Regulatory Inquiry & Complaints Senior ... Compliance Analyst assists in the implementation of Prime's ...organization, or other highly regulated industry, including experience with Medicare , Medicaid, and the Affordable Care Act (ACA) +… more
- Highmark Health (Lansing, MI)
- …This job is responsible for planning, designing, implementing, and maintaining the Compliance Program and its related policies to ensure the business acts within ... responsible for the administration, interpretation, and enforcement of the Compliance Program including auditing/monitoring operational processes, conducting or overseeing… more
- Molina Healthcare (Detroit, MI)
- **JOB DESCRIPTION** **Job Summary** Molina Healthcare's Compliance team supports compliance operations for all Molina product lines enterprise wide. It is a ... centralized corporate function supporting compliance activities at individual state...+ Performs Plan Required Reporting. + Interpret and analyzes Medicare , Medicaid and MMP Required Reporting Technical Specifications. +… more
- University of Michigan (Ann Arbor, MI)
- Medical Coder Compliance Spec Apply Now **Job Summary** Perform coding quality audits on outpatient records to assure appropriateness, accuracy, and compliance ... ICD-10-CM code assignments, and modifier assignment in accordance with Center of Medicare and Medicaid Service (CMS) Guidelines, AMA and AHA Official ICD-10-CM… more
- Gentiva (Flint, MI)
- …+ Supervise all volunteer activity within the designated service area. + Maintain compliance with the Medicare Hospice Conditions of Participation 5% volunteer ... requirement. + Assess patient and family needs for volunteer services and coordinate appropriate placements. + Recruit, train, and retain Administrative, Direct Care, Vigil, and Bereavement volunteers. + Facilitate volunteer orientation and annual training… more
- Starfish Family Services, Inc. (Livonia, MI)
- …in customer service, compliance , and technical systems. + Ensure compliance with HIPAA, Medicaid/ Medicare , DHS requirements, and other regulatory standards. ... excellent customer service, efficient scheduling, accurate insurance verification, and compliance with agency and regulatory requirements. The Supervisor is… more
- Humana (Lansing, MI)
- …help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing home health, SNF, DME, dual Medicare ... the appropriateness of services provided by other healthcare professionals in compliance with review policies, procedures, and performance standards. All work occurs… more
- Molina Healthcare (Warren, MI)
- **Job Description** **Job Summary** Provides leadership to the Medicare Duals team and plays a critical role in advancing the Medicare Integrated Duals segment ... strategic priorities. Develops and executes Medicare strategies, including state-specific and product-specific growth initiatives. Leads high-priority projects… more
- Humana (Lansing, MI)
- …service should be authorized. All work occurs within a context of regulatory compliance , and work is assisted by diverse resources, which may include national ... internal teaching conferences, and other reference sources. Medical Directors will learn Medicare and Medicare Advantage requirements and will understand how to… more
- Humana (Lansing, MI)
- …customers at the center of everything it does. Are you passionate about the Medicare population, looking for a role in management with the ability to directly impact ... self-driven individuals to join our team. Our Senior Manager, Medicare Sales, motivates and drives a team of ...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more