- Prime Therapeutics (Lansing, MI)
- …drives every decision we make. **Job Posting Title** VP Government Programs - Medicare & Managed Medicaid (REMOTE) **Job Description** The Vice President ... Government Programs - Medicare & Managed Medicaid is responsible for the development, administration, and execution of strategic plans that advance Prime's… more
- Humana (Lansing, MI)
- …efforts are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. ... a part of our caring community and help us put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business Intelligence… more
- Humana (Lansing, MI)
- …**Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other ... Utilization management experience in a medical management review organization, such as Medicare Advantage, managed Medicaid , or Commercial health insurance. +… more
- Humana (Lansing, MI)
- …efforts are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. ... a part of our caring community and help us put health first** The Sr. Medicare (PPS) Provider Hospital Reimbursement Analyst will be an integral part of the Pricer… more
- Humana (Warren, MI)
- …efforts are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. ... The MarketPoint Career Channel Team is looking for skilled Medicare Field Sales Agents. This is a field-based role,...community. As part of a collaborative team of 8-12 Medicare Sales Agents, you'll work under the guidance of… more
- Molina Healthcare (Sterling Heights, MI)
- …with clinical leadership and quality improvement teams. * Facilitates conformance to Medicare , Medicaid , NCQA and other regulatory requirements. * Reviews ... quality referred issues, focused reviews and recommends corrective actions. * Conducts retrospective reviews of claims and appeals and resolves grievances related to medical quality of care. * Attends or chairs committees as required such as credentialing,… more
- McLaren Health Care (Flint, MI)
- …our Indiana-based health plan, working with the State of Indiana and Centers for Medicare and Medicaid Services to bring you the Hoosier Healthwise and Healthy ... We are looking for a Quality Administrator Medicare , to join us in leading our organization...strategizing, and improving quality performance with a focus on Medicare Star ratings. This position supports the design, development,… more
- CenterWell (Lansing, MI)
- …+ Collaborate with market partners and HPS team members to prioritize project requests + Develop project plans, timelines and update cadence for all projects + ... **Become a part of our caring community and help us put health first** The Project Management Lead manages all aspects of a project, from start to finish, so that it is completed on time and within budget. The Project Management Lead works on problems of… more
- Fresenius Medical Center (Wyoming, MI)
- …insurance options: + Educates on the availability of alternative insurance options (ie, Medicare , Medicaid , Medicare Supplement, State Renal programs and ... + Discusses insurance options when insurance contracts are terminated. Responsibilities involving Medicare and Medicaid include but are not limited to: +… more
- Humana (Lansing, MI)
- …internal teaching conferences, and other reference sources. Medical Directors will learn Medicare , Medicare Advantage, and Medicaid requirements and will ... **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other… more