- Molina Healthcare (Detroit, MI)
- …quality compliance with National Committee for Quality Assurance (NCQA) and Centers for Medicare and Medicaid Services (CMS). * Assists with the recruitment and ... orientation of new psychiatric medical directors. * Ensures all behavioral health programs and policies are in line with industry standards and best practices. * Assists with new program implementation and supports for health plan in-source behavioral health… more
- CVS Health (Royal Oak, MI)
- …clinical models. You can have life-changing impact on our members who are enrolled in Medicare and Medicaid and present with a wide range of complex health and ... social challenges. With compassionate attention and excellent communication, we collaborate with members, providers, and community organizations to address the full continuum of our members' health care and social determinant needs. Join us in this exciting… 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
- McLaren Health Care (Detroit, MI)
- …outside regulatory agencies, such as HIPAA, PCMH, OSHA, CLIA and the Centers for Medicare and Medicaid Services (CMS) * Respond to emergency situations quickly ... and appropriately * Perform other responsibilities as requested **Qualifications:** _Required:_ _ * _ _High school diploma or equivalent and six months experience as a Medical Assistant or a Patient Care Tech._ _OR_ _ * _ _High school diploma or equivalent and… more
- Integra Partners (Troy, MI)
- …2 years of UM experience in a managed care, payor environment + Experience with Medicare and Medicaid (not required, but highly desirable) + Experience with UM ... authorizations and appeals for DMEPOS (not required, but highly desirable) + Experience with Medical Necessity Criteria including but not limited to InterQual, CMS guidelines, health plan medical policies, etc. + Experience writing denial letters is preferred… 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
- 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
- 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
- Henry Ford Health System (Jackson, 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… more
- Corewell Health (Stevensville, MI)
- …opening its doors in 2014. We are a 111-bed Skilled Nursing Facility that is Medicare and Medicaid Certified. The facility sits on Hansen Care Park's beautiful, ... wooded property- 33 private rooms and 39 semi-private rooms, spacious shower and restroom facilities, beauty salon and barber shop services, gorgeous wooded views and walking paths, state of the art rehabilitation areas for those who need physical,… more