- Humana (Lansing, MI)
- …of established clinical experience + Knowledge of the managed care industry including Medicare , Medicaid and or Commercial products + Possess analysis and ... are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. … 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** Individual Medicare Advantage (iMA) Rapid Solutions owns the MA Pricing Model (web app hydrated via… more
- Molina Healthcare (Grand Rapids, MI)
- …documents. + Lead regularly scheduled business meetings. + Interpret and analyze Medicare and Medicaid communications. + Review and interpret internal dashboards ... **JOB DESCRIPTION** **Job Summary** Molina Healthcare's Medicare Compliance team supports Medicare operations for the Molina Medicare product lines. It is a… 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
- Molina Healthcare (Sterling Heights, MI)
- …their financial and clinical performance is achieving desired results + Keep abreast of Medicaid and Medicare reforms and their impact on Molina Healthcare **JOB ... + 3 - 5 years supervisory experience + Demonstrated understanding of Medicaid and Medicare programs or other healthcare plans + Experience with Databricks +… 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)
- …responsible for ensuring the accurate and timely submission of encounter data to Medicaid , Medicare , and DSNP states, while maintaining adherence to all ... Lead is responsible for ensuring the integrity and accuracy of Medicaid and Medicare encounter data across multiple trading partners. This role collaborates with… more
- Humana (Lansing, MI)
- … Guidance on following and reviewing home health, SNF, DME, dual Medicare / Medicaid and Waiver requests. The Medical Director provides medical interpretation ... are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. **Equal… more
- Humana (Lansing, MI)
- … Guidance on following and reviewing home health, SNF, DME, dual Medicare / Medicaid and Waiver requests. The Medical Director provides medical interpretation ... are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. **Equal… more
- Humana (Lansing, MI)
- …hours** **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