- Cognizant (Lansing, MI)
- …billing, with strong knowledge of RARC and CARC codes. . Expertise in Medicare , Medicaid , Managed Care, and Commercial payer processes. . Deep understanding ... reduce denials. You'll work closely with payers to ensure timely reimbursement and contribute to operational excellence through data-driven insights and… more
- Molina Healthcare (MI)
- …modeling current and future contract rate proposals. * Research, analyze, and consult Medicaid and Medicare reimbursement methodologies, evaluate the impact ... affordably. Performs research, financial modeling, and analysis of complex healthcare claims data (medical, pharmacy and ancillary) to deliver practical, actionable… more
- Molina Healthcare (Detroit, MI)
- …modeling current and future contract rate proposals. + Research, analyze, and consult Medicaid and Medicare reimbursement methodologies, evaluate the impact ... affordably. Performs research, financial modeling, and analysis of complex healthcare claims data (medical, pharmacy and ancillary) to deliver practical, actionable… more
- Molina Healthcare (Sterling Heights, MI)
- …+ Knowledge and experience with federal regulatory policy resources including Centers for Medicare & Medicaid Services (CMS) and the Affordable Care Act (ACA). ... and/or functional requirements related to but not limited to coverage, reimbursement , and processing functions to support systems solutions development and… more
- CVS Health (Kalamazoo, 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 ... + Conducts assessments that consider information from various sources, such as claims , to address all conditions including co-morbid and multiple diagnoses that… 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...plan with dollar-for-dollar match up to 5% + Tuition Reimbursement + PTO accrual beginning Day 1 Note: Benefits… more
- CVS Health (Lansing, 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 ... + Conducts assessments that consider information from various sources, such as claims , to address all conditions including co-morbid and multiple diagnoses that… 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. ... care operations (utilization management, disease management, HEDIS quality measures, claims processing, etc.) * Advanced understanding on health care financial… more
- CVS Health (Detroit, 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 ... + Conducts assessments that consider information from various sources, such as claims , to address all conditions including co-morbid and multiple diagnoses that… more