- 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
- 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
- State of Michigan (MI)
- …to perform survey and certification activities on behalf of the Centers for Medicare and Medicaid Services (CMS). The health care surveyor position performs ... Minimum Qualifications Test (SMQT) in accordance with the Centers for Medicare and Medicaid Services' standards and procedures. All positions must abide by state… more
- Molina Healthcare (Detroit, MI)
- …according to the SIU's standards. Position must have thorough knowledge of Medicaid / Medicare /Marketplace health coverage audit policies and be able to apply ... data from all types of healthcare providers that bill Medicaid / Medicare /Marketplace. **KNOWLEDGE/SKILLS/ABILITIES** + Ensure investigators are managing their… more
- CenterWell (Lansing, MI)
- …**Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other ... teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and Medicare Advantage requirements and will understand how to… more
- Starfish Family Services, Inc. (Livonia, MI)
- …service, compliance, and technical systems. + Ensure compliance with HIPAA, Medicaid / Medicare , DHS requirements, and other regulatory standards. + Monitor ... eligibility requirements, and the continuum of care. + Knowledge of Medicaid , Medicare , and private insurance billing processes. + Ability to analyze and… more
- Integra Partners (Troy, MI)
- …written and oral communication skills + Experience with DMEPOS desired + Medicare / Medicaid experience a plus Benefits Offered + Competitive compensation and ... annual bonus program + 401(k) retirement program with company match + Company-paid life insurance + Company-paid short term disability coverage (location restrictions may apply) + Medical, Vision, and Dental benefits + Paid Time Off (PTO) + Paid Parental Leave… 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. ... **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic… more
- Prime Healthcare (Port Huron, MI)
- …Healthgrades Patient Safety Excellence Award, rated four stars by the Centers for Medicare & Medicaid Services and earned The Joint Commission's Gold Seal ... of Approval(R) for Hospital Accreditation by demonstrating continuous compliance with its performance standards. Learn more atwww.mylakehuron.com. As a member of Prime Healthcare, Lake Huron Medical Center is proud to be part of a system recognized as one of… 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. ... **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic… more