- Molina Healthcare (MI)
- …in driving successful launches of new processes, systems, and operational models across Medicaid , Medicare , and Marketplace lines of business. We are seeking a ... leader with proven experience in **launch planning, execution, and post-implementation stabilization** . **Key responsibilities include:** + Leading operational readiness efforts for new processes, systems, and operational initiatives across provider data and… more
- Wayne State University (Detroit, MI)
- …services or resources with local and state agencies. Maintain current knowledge of Medicaid / Medicare and other Health Insurance Plans. Performs data entry into ... Electronic Medical Records, Care Ware, and other database systems. Monitor and track patient supportive services. Create required program reports. Works with patients on addressing payment concerns or unpaid invoices. Collaborate with clinic leadership and… more
- Prime Therapeutics (Lansing, MI)
- …the State where the position is located + Experience within the PBM industry, Medicaid , Medicare , and health plans Every employee must understand, comply with ... and attest to the security responsibilities and security controls unique to their job, and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures Every employee must be able to perform the essential… more
- Molina Healthcare (Ann Arbor, MI)
- …familiarity with various managed healthcare provider compensation methodologies, primarily across Medicaid and Medicare lines of business, including but not ... limited to; fee-for service, capitation, and various forms of risk, ASO, etc. **Preferred Education** Bachelor's or master's degree. **Preferred Experience** + 5+ years' experience in managed healthcare administration and/or Provider Services. + 5+ years'… more
- Intermountain Health (Lansing, MI)
- …physician back-end revenue cycle (Payment Posting, Billing, Follow-Up) required + Knowledge of Medicaid and Medicare billing regulations required + Two (2) years ... of experience in hospital or physician insurance related activities (Authorization, Billing, Follow-Up, Call-Center, or Collections) preferred **Physical Requirements** + Operate computers and other office equipment requiring the ability to move fingers and… more
- Intermountain Health (Lansing, MI)
- …cycle (Payment Posting, Billing, Follow-Up, Collections) required + Knowledge of Medicaid and Medicare billing regulations required **Physical Requirements** + ... Operate computers and other office equipment requiring the ability to move fingers and hands. + Remain sitting or standing for long periods of time to perform work on a computer, telephone, or other equipment. + May require lifting and transporting objects and… more
- Sumitomo Pharma (Lansing, MI)
- …+ Proficient knowledge and understanding of the payer landscape including commercial, Medicaid , and Medicare or relevant experience. + Demonstrates the ability ... to analyze complex data to develop strategic and actionable business plans to deliver sales results. + Candidates must have excellent communication & organizational skills and be proficient with technology platforms and business hardware/software. **Education… more
- Molina Healthcare (Warren, MI)
- …and troubleshooting. **Job Duties** + Research, review, and decipher state-specific Medicaid and Medicare reimbursement methodologies for providers, including ... hospitals and facilities. + Developing expertise in complex groupers (APG, EAPG, APR-DRG, MS-DRG, etc.) utilized in reimbursement priced through PPS payment methodologies. + Support implementation of new pricers including: + Reviewing pricing software vendor… more
- Molina Healthcare (Warren, MI)
- …observations into actions/interventions to improve financial performance. * Advanced understanding of Medicaid and Medicare programs or other health care plans. ... * Advanced analytical work experience within the health care industry (ie, hospital, network, ancillary, medical facility, health care vendor, commercial health insurance, large physician practice, managed care organization, etc.) * Advanced proficiency with… more
- Molina Healthcare (MI)
- …current and future contract rate proposals. * Research, analyze, and consult Medicaid and Medicare reimbursement methodologies, evaluate the impact of ... reimbursement changes, educate/consult the health plans on the financial impact. * Work independently to support and validate Provider Network contracting and unit cost management activities through financial and network pricing modeling, analysis, and… more