- Integra Partners (Troy, MI)
- …and external partners + Performs other duties as assigned EDUCATION: Active, unrestricted Registered Nurse , Licensed Vocational Nurse , or Licensed Practical ... The Utilization Management (UM) Nurse Team Lead plays a key role in...UM Coordinators to ensure compliance with regulatory requirements and health plan policies + Maintain compliance with all accrediting… more
- CenterWell (Lansing, MI)
- …Experience a plus + Current nursing experience in Hospital, SNF, LTAC, DME or Home Health . + Bilingual We offer tangible and intangible benefits such as ... as a whole. Conviva Care Solutions is seeking a RN who will collaborate with other health ...senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy… more
- Corewell Health (Grand Rapids, MI)
- Job Summary Under general direction, is a liaison for health plan initiatives with physician hospital organizations, physician organizations state-wide and community ... multiple interventions, programs and data in support of Network efficiency, health outcomes and patient experience. + Identifies, monitors, coordinates and manages… more
- Henry Ford Health System (Troy, MI)
- …care to complex and specialty care, health insurance, a full suite of home health offerings, virtual care, pharmacy, eye care and other health ... analyze, and resolve issues at a high level. + Knowledge of Medicare , Medicaid, Medicaid OPPS reimbursement, and other third- party billing rules/coverage,… more
- Henry Ford Health System (Troy, MI)
- …care to complex and specialty care, health insurance, a full suite of home health offerings, virtual care, pharmacy, eye care and other health ... and federal and state regulations related to rules/coverage. + Knowledge of Medicare , Medicaid, Blue Cross and other third-party payers billing and reimbursement… more
- Henry Ford Health System (Troy, MI)
- …care to complex and specialty care, health insurance, a full suite of home health offerings, virtual care, pharmacy, eye care and other health ... to comply with third party regulations. This includes knowledge of Medicare /Medicaid regulations as well as understanding of managed care contracts. 15.Actively… more
- University of Michigan (Ann Arbor, MI)
- …goals of Michigan Medicine **Required Qualifications + An Associate degree in Health Information Technology withRHIT certificationOR Associate degree RN + At ... of care, administrative and outpatient denials. They manage and respond to Medicare , Medicare Advantage, Varis, Medicaid and other various commercial audits.… more
- Humana (Lansing, MI)
- **Become a part of our caring community and help us put health first** The Clinical Strategy Team is a multi-disciplinary team focused on using data analysis and ... improve experiences for our members and providers, drive positive health outcomes, and reduce total cost of care. We...degree (eg MD, DO, PharmD, APRN, PA, NP, BSN, RN ) + Highly creative and able to think outside… more
- CenterWell (Lansing, MI)
- …largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is ... part of our caring community and help us put health first** The National Director, Care Integration Strategy &...and reduce costs for high-risk senior populations in full-risk Medicare arrangements. The Director will lead and oversee the… more
- Jackson County Medical Care Facility (Jackson, MI)
- Jackson County Medical Care Facility is a 194-bed, Eden Alternative certified home where residents, family members, and Care Partners are actively involved in their ... care decisions and lifestyle choices, creating a supportive home environment. JCMCF was recognized as one of the...Records Specialist, you would be responsible to assist the RN -MDS Coordinator with the coding, documentation and data management,… more