- Humana (Lansing, MI)
- …actuarial and business needs for specific product lines. The Actuarial Analyst 2, General work assignments are varied and frequently require interpretation and ... community and help us put health first** The Actuarial Analyst 2, General provides actuarial support across a broad...to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel,… more
- Prime Therapeutics (Lansing, MI)
- …a healthcare or PBM organization, or other highly regulated industry, including experience with Medicare , Medicaid , and the Affordable Care Act (ACA) + Must be ... and drives every decision we make. **Job Posting Title** Sr. Compliance Analyst - Remote **Job Description** The Regulatory Inquiry & Complaints Senior Compliance… more
- Henry Ford Health System (Troy, MI)
- …+ Excellent analytical skills. + Understanding of various product reimbursements ( Medicaid , Medicare , Commercial). + Highly Proficient in Microsoft Excel: ... inpatient and high dollar outpatient payments for various payors, including MA, Medicaid and Commercial. 8. Create prospective and retrospective analyses to assess… more
- Molina Healthcare (MI)
- …experience on researching, presenting and documenting is required, + Experience with Medicare , Medicaid and Marketplace is required. + Medical coding experience ... data among operational and claims systems and application of business rules as they apply to each database. Validate...to be housed on databases and ensure adherence to business and system requirements of customers as it pertains… more
- Corewell Health (Grand Rapids, MI)
- …with CMS & State of Michigan regulations. Maintains up-to-date knowledge of Medicare / Medicaid rules and regulations. + Facilitate the timely and accurate ... resolution to appropriate leadership. + Apply strong analytical skills and business knowledge to the investigation, analysis and recommendation of creative solutions… more
- CVS Health (Lansing, MI)
- …+ Pharmacy Investigative experience + Marketplace Broker Investigative experience + Medicaid and Medicare experience **Education** + Bachelor's degree in ... tools, social media and internet research. + Ability to Travel for Business purposes. **Preferred Qualifications** + Certified Professional Coder (CPC), AHFI, CFE +… more
- Corewell Health (Grand Rapids, MI)
- …agreements, products offered, State and Federal laws related to fraud, waste or abuse, Medicare and Medicaid regulations, etc. + Ability to work effectively with ... agents and vendors. Qualifications Required + Bachelor's Degree or equivalent Health, Business or statistics + 2 years of relevant experience Detection, prevention… more
- Molina Healthcare (Sterling Heights, MI)
- …synthesize complex information. **PREFERRED QUALIFICATIONS:** + Experience with Medicare , Medicaid , and Marketplace lines of business . + Certified ... and executes tasks and projects to ensure Centers for Medicare & Medicaid Services (CMS) and State...+ At least 7 years of experience as a Business Analyst or Program Manager in a… more
- Molina Healthcare (Grand Rapids, MI)
- …to synthesize complex information. **PREFERRED QUALIFICATIONS:** + Experience with Medicare , Medicaid , and Marketplace lines of business . + PMP, Certified ... + At least 7 years of experience as a Business Analyst or Program Manager in a...experience. + At least 3 years of Experience with Medicaid and/or Medicare . + Proven experience owning… more