- Molina Healthcare (Ann Arbor, MI)
- …and compliance to SVP, Clinical Operations and CMO, Enterprise Medicare Unit, + Develops strategic direction for Star Rating improvement through ongoing ... existing healthcare quality improvement initiatives and education programs supporting Medicare Star Ratings improvement for Clinical HEDIS measures. Responsible for… more
- Humana (Lansing, MI)
- …service should be authorized. All work occurs with a context of regulatory compliance , and work is assisted by diverse resources which may include national clinical ... teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and Medicare Advantage requirements, and will understand how to… more
- Humana (Lansing, MI)
- …at the Inpatient level. All work occurs within a context of regulatory compliance , and work is assisted by diverse resources, which may include national clinical ... teaching conferences, and other reference sources. Medical Directors will learn Medicare , Medicaid, and Medicare Advantage requirements and will understand… more
- Humana (Lansing, MI)
- …performance improvement for healthcare outcomes and patient experience within our Medicare population. This role will lead execution of tactics, collaborative ... of programs and their impact to results on the Medicare Health Outcomes Survey and patient experience. This role...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
- Humana (Lansing, MI)
- …analytics that are meaningful to develop foundational programs for our Medicare population. This role will lead execution of tactics, collaborative development ... or programs and their impact to results on the Medicare Health Outcomes Survey and patient experience. This role...+ Develop and manage HOS call campaigns and ensure compliance with TCPA regulations + Expand and ensure all… more
- Humana (Lansing, MI)
- …(IFG). The Associate Director, Sales Support requires a solid understanding of the Medicare industry, FMO relationships with carriers, and how to lead and develop a ... implemented and followed. They utilize their knowledge of the Medicare industry to ensure that all practices and procedures...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
- Humana (Lansing, MI)
- …insights strategy that supports the improvement of health outcomes within our Medicare population. This role will lead and coordinate survey administration strategy ... data insights library and impact to results on the Medicare Health Outcomes Survey. This role will advise executives...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
- Humana (Lansing, MI)
- …Clinical Leadership teams to ensure utilization reviews comply with Centers for Medicare & Medicaid Services (CMS) regulations as well as Michigan Dual Special ... and Human Services (MDHHS) standards. + Works in conjunction with Humana's Medicare UM Committees to ensure adoption and consistent application of appropriate… more
- Humana (Lansing, MI)
- …the appropriateness of services provided by other healthcare professionals in compliance with review policies, procedures, and performance standards. Begins to ... and authorship. Exercises independence in meeting departmental expectations, and meets compliance timelines. **Required Qualifications** + MD or DO degree + 5+… more
- Corewell Health (Farmington Hills, MI)
- …information, educating and providing information as necessary. Collects and documents Medicare Questionnaire, issue Medicare Inpatient Letter & Medicare ... by Government mandates. Scan appropriate documents. Manage all responsibilities within Compliance guidelines as outlined in the Hospital and Department Compliance… more