- Molina Healthcare (Detroit, MI)
- …* Current State Medical License without restrictions (free of sanctions from Medicaid or Medicare ) **PREFERRED EDUCATION:** Master's in Business Administration, ... Public Health, Healthcare Administration, etc. **PREFERRED LICENSE, CERTIFICATION, ASSOCIATION:** Board Certification (Pediatrics, Family Practice, Ob/Gyn or Internal Medicine). **PHYSICAL DEMANDS:** Working environment is generally favorable and lighting and… more
- Molina Healthcare (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 (Ann Arbor, 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)
- …to ensure successful submission and reconciliation of encounter submissions to Medicaid / Medicare . Ensures encounter submissions meet or exceed all compliance ... data and develops tools to enhance the encounter acceptance rate by Medicaid / Medicare . Looking for long-term improvements of encounter submission processes.… 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)
- …ACO (DVACO) is an accountable care organization that participates in the Centers for Medicare and Medicaid Services' Medicare Shared Savings Program (MSSP), ... are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. … more
- Molina Healthcare (Sterling Heights, MI)
- …Ownership** + Assists and executes tasks and projects to ensure Centers for Medicare & Medicaid Services (CMS) and State regulatory requirements are met ... a Managed Care Organization (MCO) or health plan setting, including experience in Medicaid and/or Medicare , or equivalent combination of relevant education and… more
- Humana (Lansing, MI)
- …Preferred Qualifications + Knowledge of the managed care industry including Medicare Advantage, Managed Medicaid , or other Medical management organizations, ... Utilization management experience in a medical management review organization, such as Medicare Advantage and managed Medicaid . + Physical Medicine and… more
- Humana (Lansing, MI)
- …Humana's Clinical Leadership teams to ensure utilization reviews comply with Centers for Medicare & Medicaid Services (CMS) regulations as well as Michigan Dual ... 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)
- …**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