• Field Medical Director, Interventional Cardiology…

    Evolent (Lansing, MI)
    …under current exclusion or sanction by any state or federal health care program, including Medicare or Medicaid , and is not identified as an "excluded person" by ... Human Services or the General Service Administration (GSA), or reprimanded or sanctioned by Medicare . + No history of a major disciplinary or legal action by a state… more
    Evolent (10/29/25)
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  • Therapy Access Manager…

    United Therapeutics (Detroit, MI)
    …Teams + Advanced knowledge of medical insurance terminology + Knowledge of Centers of Medicare & Medicaid Services (CMS) policies and processes with expertise in ... Medicare (Part B and Part D) Job Location This position will require candidates to live within the assigned territory. This includes North Dakota, South Dakota,… more
    United Therapeutics (10/11/25)
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  • Physical Therapist - Home Health - 40 Hours - Days

    Henry Ford Health System (Jackson, MI)
    …deliver affordable, high-quality care across a wide range of insurance plans including Medicare , Medicaid , and private options. GENERAL SUMMARY: The Home Care ... Occupational Therapist is responsible for the delivery of patient care through the process of assessment, development, implementation, education and revision of treatment programs as necessary for provision of age-specific direct care/services to patients.… more
    Henry Ford Health System (10/09/25)
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  • Physical Therapist - Home Health - 40 Hours - Days

    Henry Ford Health System (Jackson, MI)
    …affordable, high-quality care across a wide range of insurance plans including Medicare , Medicaid , and private options. GENERAL SUMMARY: The Physical Therapist ... provides direct patient care utilizing appropriate age-specific standards of practice for physical therapists in regard to all patient populations served. Works independently and collaborates well with other team members in obtaining patient-centered goals… more
    Henry Ford Health System (10/09/25)
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  • Case Manager, Registered Nurse (Remote, Michigan)

    CVS Health (Lansing, MI)
    …Experience or a willingness to thoroughly learn the role of care management within Medicare and Medicaid managed care. + Familiarity with community resources and ... coordination experience **Preferred Qualifications** + Experience providing care management for Medicare and/or Medicaid members + Experience working with… more
    CVS Health (11/28/25)
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  • Care Manager Specialist (Remote, Michigan)

    CVS Health (Lansing, MI)
    …Experience or willingness to thoroughly learn the role of care management within Medicare and Medicaid managed care. + **Community Resources:** Familiarity with ... of the position **Preferred Qualifications** + Experience providing care management for Medicare and/or Medicaid members + Experience working with individuals… more
    CVS Health (11/28/25)
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  • Associate Specialist, Appeals & Grievances

    Molina Healthcare (Ann Arbor, MI)
    …in accordance with the standards and requirements established by the Centers for Medicare and Medicaid Services (CMS). **Essential Job Duties** * Enters denials ... Qualifications** * Customer/provider experience in a managed care organization ( Medicaid , Medicare , Marketplace and/or other government-sponsored program), or… more
    Molina Healthcare (11/21/25)
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  • RN UM Clinical Appeals Nurse Remote

    Molina Healthcare (MI)
    …Common Procedure Coding (HCPC). * Experience demonstrating knowledge of Centers for Medicare and Medicaid Services (CMS) guidelines, MCG, InterQual or other ... medically appropriate clinical guidelines, Medicaid , Medicare , CHIP and Marketplace, applicable state regulatory requirements, including ability to easily access… more
    Molina Healthcare (11/14/25)
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  • Medical Director Aetna Duals Center of Excellence

    CVS Health (Lansing, MI)
    …years of clinical practice experience. Two (2) + years of experience in managed care ( Medicare and/or Medicaid ) MD or DO; Board certification in an ABMS or AOA ... one state where we have an Integrated plan. Experience with managed care ( Medicare and Medicaid ) utilization review preferred. **Education** MD (Doctor of… more
    CVS Health (11/13/25)
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  • Specialist, Appeals & Grievances

    Molina Healthcare (Detroit, MI)
    …with the standards and requirements established by the Centers for Medicare and Medicaid **KNOWLEDGE/SKILLS/ABILITIES** + Responsible for the comprehensive ... including coordination of benefits, subrogation, and eligibility criteria. + Familiarity with Medicaid and Medicare claims denials and appeals processing, and… more
    Molina Healthcare (11/07/25)
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