- Molina Healthcare (Detroit, MI)
- …experience in health plan setting in government programs management (Contract Manager ) **Preferred Experience** 7-9 years To all current Molina employees: If ... you are interested in applying for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. Pay Range: $77,969 -… more
- Molina Healthcare (Ann Arbor, MI)
- …Enrollment activities (along with other Core Ops areas of responsibilities) within Medicare and Medicaid. Role is predicated on building relationships with vendors, ... the Service Level Agreements between the parties. **Job Duties** + Develops Medicare and Medicaid vendor strategies aligned with CMS and State regulations, including… more
- Molina Healthcare (Detroit, MI)
- …members, and manager . Basic understanding of managed healthcare systems and Medicare . **PREFERRED EXPERIENCE:** Experience with Medicare and Medicare ... Molina Healthcare is hiring for its outbound Medicare Member Engagement team. Candidates who are Bilingual...8am to 430pm Pacific Standard Time, Monday through Friday. Medicare Member Engagement Specialists will make outbound welcome calls… more
- Molina Healthcare (Ann Arbor, MI)
- …provisions, and internal policies and procedures. * Supports the Operational Oversight Manager , Director, and team in the general development of the Operational ... reporting exists to demonstrate compliance to regulatory requirements. * Supports Manager and Director with developing the Operational Oversight Work Plan,… more
- Molina Healthcare (Ann Arbor, MI)
- …speed to answer, and average hold time are compliant with Centers for Medicare and Medicaid Services (CMS) regulations. + Ensures that adequate staffing coverage is ... leadership with monitoring and oversight of Molina's contracted Pharmacy Benefit Manager (PBM) for pharmacy contractually delegated functions. + Responsible for key… more
- Molina Healthcare (Ann Arbor, MI)
- …monitor, and troubleshoot Hadoop-based infrastructure using tools such as Cloudera Manager , Ambari, and Zookeeper. * Enforce data quality, security, and compliance ... in deploying and monitoring big data infrastructure with Ambari, Cloudera Manager , and Zookeeper. * Solid understanding of data warehousing, data validation,… more
- Humana (Lansing, MI)
- …develop engagement best practices, and design clinical solutions for members who have Medicare and Medicaid. The Lead Product Manager partners across various ... our dual members - members that qualify for both Medicare and Medicaid. The Lead Product Manager sits in the center of strategy, design, technology, clinical,… more
- Humana (Detroit, MI)
- …an assigned area in Wayne or Macomb county, to conduct in home visits with Medicare /Medicaid members.** The Field Care Manager Nurse 2 employs a variety of ... and help us put health first** The Field Care Manager Nurse 2 assesses and evaluates member's needs and...to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities… more
- Humana (Lansing, MI)
- …part of our caring community and help us put health first** The Manager , Fraud and Waste conducts investigations of allegations of fraudulent and abusive practices. ... The Manager , Fraud and Waste works within specific guidelines and...+ Minimum of 3 yrs health insurance claims or Medicare experience + Minimum 3 years of experience with… more
- Gentiva (Portage, MI)
- …benefit package. Read on to learn more! We're looking for a **Patient Care Manager Senior/Clinical Manager ** to join our team. You will report directly to ... new physicians and facilities, durable medical equipment (DME) pickup, Medicare patient eligibility, obtaining authorization and reauthorization as needed,… more