- Humana (Lansing, MI)
- …to our rapidly growing Medicaid product in various new states as well as our Medicare membership growth. This role is 100% work at home in the Eastern Time Zone. ... business-area created technology solutions revolving around Humana's Medicaid and Medicare growth. Strong communication and organizational skills will be used… more
- Humana (Lansing, MI)
- …interrelate across segments and/or enterprise-wide. **Regional VP of Health Services, Humana Medicare Advantage** As the Regional VP of Health Services, you will ... and relationship builder, ensuring alignment with Humana's mission and Medicare Advantage goals. **Primary Responsibilities:** Clinical Engagement & Provider… more
- Belle (Detroit, MI)
- …(medical, dental, vision, 401k) + Be part of a mission-driven team helping Medicare seniors live healthier, longer lives What You'll Do + Provide routine telehealth ... visits with Medicare patients (E/M and Chronic Care Management) + Create...CHWs) + Ensure thorough documentation in our EHR and compliance with quality measures + Engage patients in preventive… more
- Humana (Lansing, MI)
- …to Succeed** + Bachelor's Degree + Minimum of 3 yrs health insurance claims or Medicare experience + Minimum 3 years of experience with Fraud, Waste, and Abuse in ... a group of seasoned professionals. + Proven knowledge in Medicare regulations + Excellent PC skills MS Excel and...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
- Humana (Lansing, MI)
- …time with demonstrated advanced communication and interpersonal skills. This is a very compliance driven and highly visible program at Humana. The nature of the work ... concurrently navigating multiple computer applications. Due to the auto dialer process and compliance needs of the business there is limited day to day flexibility… more
- Gentiva (Jackson, MI)
- …program by managing patient care activities, supervising clinical staff, and ensuring compliance with all company policies and regulatory standards. **As a Senior ... + Lead and support hospice patient care operations to ensure quality and compliance + Supervise, teach, evaluate, and develop nursing and clinical associates +… more
- Molina Healthcare (MI)
- …oversight of processes that track, evaluate, and submit encounter deletions for Medicare Advantage, ACA, and Medicaid lines of business. This role has ... decision-making accountability for ensuring compliance with complex regulatory requirements, protecting the integrity of enterprise revenue, and enabling the… more
- Molina Healthcare (Warren, MI)
- …Molina Healthcare's overall mission, core values, and strategic plan and in compliance with all relevant federal, state and local regulations. Plans, organizes, ... and Joint Operating Committees. * Manages and reports network adequacy for Medicare , Marketplace, and Medicaid services. * In conjunction with direct management and… more
- Humana (Lansing, MI)
- …Accountable for actuarial certifications on rate filings, including attesting to compliance with state and federal rating and benefit regulations. Understands ... **Preferred Qualifications** + Experience with SQL or VBA + Medicare experience Travel: While this is a remote position,...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
- Humana (Lansing, MI)
- …Adhere to established guidelines and procedures to ensure consistency and compliance . **Potential Duties** + Advocate for our agile development approach and ... leadership and consulting. + Knowledge of healthcare business domains, including Medicare , Medicaid, Group, Specialty, etc. + **Development level knowledge utilizing… more