• Payment Integrity Program Manager - Health Plan

    Molina Healthcare (MI)
    …achieve operational goals and executes tasks and projects to ensure Centers for Medicare & Medicaid Services (CMS) and State regulatory requirements are met for ... and experience. + At least 3 years of Experience with Medicaid and/or Medicare . + Proven experience owning operational projects from concept to execution, especially… more
    Molina Healthcare (08/14/25)
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  • REMOTE Coder I - Ancillary, Routine Outpatient

    Trinity Health (Livonia, MI)
    …codes, and Current Procedural Terminology / Healthcare Common Procedure Coding System (HCPCS) procedure codes and all required modifiers. Utilizes coding guidelines ... established by: + The Centers for Medicare /Medicaid Services (CMS) ICD-CM Official Coding Guidelines for Coding and Reporting, ICD-PCS Official Guidelines for Coding… more
    Trinity Health (08/09/25)
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  • Field Medical Director, Interventional Cardiology…

    Evolent (Lansing, MI)
    …specialties and primary care, we seek to connect the pieces of fragmented health care system and ensure people get the same level of care and compassion we would ... Join our Utilization Management team as a Field Medical Director, Cardiovascular Specialist and use your expertise in interventional cardiology to help ensure the… more
    Evolent (07/30/25)
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  • Coding Auditor Educator

    Highmark Health (Lansing, MI)
    …to resolve issues and provide advice on new programs. Provides guidance to system entities in response to external coding audits conducted by the Medicare ... ICD-PCS, CPT and HCPCS Level II code and modifier systems , missed secondary diagnoses and procedures and ensures compliance...reviews to check code transfer accuracy from the abstracting system and the chargemaster. (10%) + Is responsible for… more
    Highmark Health (08/08/25)
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  • Director, Risk Adjustment Prospective Operations…

    Corewell Health (Grand Rapids, MI)
    …for the Enterprise Disease Burden program with the Corewell Health delivery system . In addition, the position will oversee the operations for Risk Mitigation, ... leader will need to engage executive level stakeholders to define a system strategy for risk adjustment, including strategies for provider engagement, compliance and… more
    Corewell Health (07/21/25)
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  • Biomedical Equipment Technician I,II,III

    Marshfield Clinic (Iron Mountain, MI)
    …Radiology Equipment Specialist (CRES), or Certified Laboratory Equipment Specialist (CLES) certification. **Marshfield Clinic Health System is committed ... **Job Title:** Biomedical Equipment Technician I,II,III **Cost Center:** 101651034 System Support-Biomed **Scheduled Weekly Hours:** 40 **Employee Type:** Regular… more
    Marshfield Clinic (06/18/25)
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  • Profee Medical Coder Complex Surgical Pediatric

    Banner Health (MI)
    …and regulations according to regulatory agencies for state Medicaid plans, Center for Medicare Services (CMS), Office of the Inspector General (OIG) and the Health ... least one of the following: Certified Professional Coder (CPC), Certified Coding Specialist (CCS), Certified Coding Specialist - Physician (CCS-P), Registered… more
    Banner Health (07/30/25)
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  • Health Plan Operations, Payment Integrity Program…

    Molina Healthcare (Grand Rapids, MI)
    …and experience. + At least 3 years of Experience with Medicaid and/or Medicare . + Proven experience owning operational projects from concept to execution, especially ... (CPT), International Classification of Diseases (ICD), Healthcare Common Procedure Coding System (HCPCS), Revenue Codes), and federal/state Medicaid payment rules. +… more
    Molina Healthcare (08/14/25)
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  • Facility Coding Inpatient Complex Coder

    Banner Health (MI)
    …procedures on inpatient records using ICD CM and PCS coding classification systems . Completes MS-DRG and APR-DRG assignments on inpatient records as appropriate. ... to regulatory agencies for state Medicaid plans, Center for Medicare Services (CMS), Office of the Inspector General (OIG)...degree in a health care field. Requires Certified Coding Specialist (CCS) or Certified Outpatient Coder (COC) or Certified… more
    Banner Health (07/10/25)
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  • RN Field Care Manager

    Humana (Lansing, MI)
    …assigned area in Wayne or Macomb county, to conduct in home visits with Medicare /Medicaid members.** The Field Care Manager Nurse 2 employs a variety of strategies, ... **Required Qualifications** + **Registered Nurse, Nurse Practitioner, or Clinical Nurse Specialist with** **a minimum of 1** **year in-home experience** : care… more
    Humana (08/09/25)
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