- Integra Partners (Troy, MI)
- …+ Excellent verbal/written communication and organizational skills. + Experience with Medicare and Medicaid requirements. + Familiarity with DMEPOS authorization ... and appeals processes. + Knowledge of medical necessity criteria (InterQual, CMS, health plan policies). + Prior leadership, supervisory, or team lead experience in a UM setting. Benefits Offered + Competitive compensation and annual bonus program + 401(k)… more
- Marshfield Clinic (Iron Mountain, MI)
- …have been or be excluded from participation in any federally funded program, including Medicare and Medicaid . This is a condition of employment. Employee must ... immediately notify his/her manager or the Health System's Compliance Officer if he/she is threatened with exclusion or becomes excluded from any federally funded program** **.** **Marshfield Clinic Health System is an Equal** **Opportunity/Affirmative**… more
- Veterans Affairs, Veterans Health Administration (Detroit, MI)
- …health record documentation. Knowledge of The Joint Commission requirements, Centers for Medicare and Medicaid Services (CMS), and/or health record documentation ... guidelines. Ability to manage priorities and coordinate work, in order to complete duties within required timeframes, and the ability to follow-up on pending issues. Medical Records Technician (Coder-Outpatient and Inpatient), GS-6 Experience. One year of… more
- Molina Healthcare (Warren, MI)
- …skills, healthcare experience, and a deep understanding of Centers for Medicare and Medicaid Services (CMS) programs and regulations. ... **KNOWLEDGE/SKILLS/ABILITIES** + Articulate requirements into concise and clear directions for project members (Business Owners, Developers, Testers, etc.) to understand and execute + Facilitate collaboration across departments to ensure alignment and… more
- Marshfield Clinic (Iron Mountain, MI)
- …have been or be excluded from participation in any federally funded program, including Medicare and Medicaid . This is a condition of employment. Employee must ... immediately notify his/her manager or the Health System's Compliance Officer if he/she is threatened with exclusion or becomes excluded from any federally funded program** **.** **Marshfield Clinic Health System is an Equal** **Opportunity/Affirmative**… more
- Trinity Health (Chelsea, MI)
- …with the distinction of having a double, five-star rating from the Centers for Medicare and Medicaid Services. It is accredited by the Joint Commission, and ... attracts more than 500 physicians with leading edge technology and compassionate care. As a not-for-profit hospital, Chelsea Hospital reinvests its profits into the community through programs to serve the poor and uninsured, manage chronic conditions like… more
- Henry Ford Health System (Detroit, MI)
- …of preventive service guidelines, clinical practice guidelines, behavior change theory, Medicare and Medicaid regulations and case management principles. ... Knowledge of medical ethics and legal implications related to case management. Understanding of social determinants of health and their impact on a patient's wellbeing. Well versed in facilitating community resources to meet the needs of diverse populations.… more
- Baylor Scott & White Health (Lansing, MI)
- …and reporting to stakeholders across all lines of business (Commercial, DTE, Medicare , and Medicaid ). Candidate will oversee extracting and analyzing medical ... and pharmacy claims data, translating output into business recommendations. This individual will design, develop, and support the creation of core analytics products, standardized across the organization. The Medical Trend Analytics Manager 1 will orchestrate… more
- Marshfield Clinic (Iron Mountain, MI)
- …have been or be excluded from participation in any federally funded program, including Medicare and Medicaid . This is a condition of employment. Employee must ... immediately notify his/her manager or the Health System's Compliance Officer if he/she is threatened with exclusion or becomes excluded from any federally funded program.** **Marshfield Clinic Health System is an Equal** **Opportunity/Affirmative** **Action… 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 ... Indiana Plan health insurance programs. Learn more about MDwise, Inc. at https://www.mdwise.org/ . **Position** **Overview:** The Director of Quality Programs is responsible for developing, implementing, and leading quality program strategies, policies, and… more