• Senior Coding Educator

    Humana (Lansing, MI)
    …assigned provider. The Senior Coding Educator is responsible for creating and executing the risk adjustment strategy for each provider groups. + Analyzes ... with relationship owners and HQRI + Monitors and develops strategy with leader and Relationship Owner, tailor's provider group...Coder (CRC) + Experience interacting with healthcare providers + Medicare Risk Adjustment knowledge +… more
    Humana (11/20/25)
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  • Actuarial Senior Consultant with Medicaid…

    Deloitte (Detroit, MI)
    …care and fee-for-service, Medicaid policy, budget forecasting and fiscal analyses, and risk adjustment + Support business development efforts for Federal and ... develop, and motivate my workforce? What should my AI strategy be for the HR function? Do I have...waivers (ie, 1115, 1915 b/c, 1332) + Experience with risk adjustment mechanisms + Experience with Provider… more
    Deloitte (10/10/25)
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  • Regional Manager, Value-Based Programs - REMOTE

    Molina Healthcare (Detroit, MI)
    …with setting annual targets for each VBP/VBC in conjunction with national quality and risk adjustment VPs, Regional Directors of Quality/ Risk , Director of ... revenue management, strategy , and compliance + Knowledge of value based programs, risk adjustment models, quality metrics such as HEDIS and STARS, knowledge… more
    Molina Healthcare (11/09/25)
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  • Healthcare Clinical Documentation Specialist

    Deloitte (Detroit, MI)
    …reimbursement, MS-DRG, APR-DRG, PSIs, HACs, POA, Vizient, Elixhauser, public profiling, and risk adjustment + Has strong interpersonal skills to collaborate with ... Healthcare Clinical Documentation Specialist - Senior Consultant Our Deloitte Regulatory, Risk & Forensic team helps client leaders translate multifaceted risk … more
    Deloitte (11/21/25)
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  • VP, Medical Economics

    Molina Healthcare (Warren, MI)
    …of key managed care concepts and provider reimbursement principles such as risk adjustment , capitation, FFS (Fee-for-Service), Diagnosis Related Groups (DRG's), ... JOB DESCRIPTION Job Summary Provides executive level strategy and leadership for team responsible for medical...improve financial performance. * Advanced understanding of Medicaid and Medicare programs or other health care plans. * Advanced… more
    Molina Healthcare (11/21/25)
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  • Senior Product Manager

    Humana (Lansing, MI)
    …Qualifications** + Bachelors Degree + Knowledge and/or experience within the Stars Organization, Risk Adjustment and/or Provider + PMP or CAPM Certification + ... to continue to achieve the desired outcomes. Begins to influence department's strategy . Makes decisions on moderately complex to complex issues regarding technical… more
    Humana (11/19/25)
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