- Henry Ford Health System (Detroit, MI)
- …Ensure coding practices comply with local, state, and federal guidelines and payer policies. + Lead quality improvement activities related to coding and ... documentation integrity; use results to drive actionable change. + Represent coding services on internal committees and in external forums, promoting best practices, benchmarking, and system collaboration. EDUCATION/EXPERIENCE REQUIRED: + Bachelor's degree in… more
- Corewell Health (Greenville, MI)
- …appropriate medication therapy as defined by Corewell Health guidelines and health-system/ payer formulary. + Provides leadership in identifying and developing cost ... avoidance strategies in drug therapy, promoting more cost-effective treatment and reducing waste. + Participates in pharmacy decision-making process through continual feedback and committees. + Participates in department quality and safety programs. +… more
- Tenet Healthcare (Detroit, MI)
- …order to ensure accurate bill production. Ensures compliance with third party payer requirements. 6. Reconciles and corrects rejected erroneous data transactions as ... displayed on Transmission, Control and Errors (TCE) reports. 7. Accesses computerized system to enter and/or update electronic systems as needed and to answer patients, stakeholders and other pertinent parties inquiries. Responds to general inquiries as… more
- Sumitomo Pharma (Lansing, MI)
- …for the data engineering team + Oversee master data sets (Customer, Product, Payer ) and ensure data quality, accuracy, and compliance + Lead data integration ... projects and collaborate on enhancements and functionality + Lead efforts to provide effective access to data for non-technical users through the use of database views, visual tools and tool plug-ins + Monitor and enforce data governance standards, policies,… more
- Kyndryl (Lansing, MI)
- …+ Healthcare industry experience is a strong plus, especially in payer /provider operations and care management workflows. **Preferred Qualifications: ** + 15+ ... years' experience in contact center sales, consulting, services, or transformation initiatives. + Previous experience in leading healthcare-focused journey redesign from eligibility verification to care management. + Align contact center transformation with… more
- R1 RCM (Detroit, MI)
- …of the top 100 US health systems, and handles over 270 million payer transactions annually. This scale provides unmatched operational insight to help healthcare ... organizations unlock greater long-term value. To learn more, visit: https://www.r1rcm.com . more
- Cognizant (Lansing, MI)
- …House:** TriZetto offers product solutions to the healthcare industry from streamlining payer processes to automating insurance operations. The practice has its own ... ecosystem of businesses including positions in marketing, project management, and technical roles - such as developers and analysts. **Products include:** + Clinical CareAdvance and CareAdvance Provider + EngageMember + EngageProvider + Facets + NetWorX… more
- Highmark Health (Lansing, MI)
- …both the return on investment (ROI) and other decisions on the payer partnership constructs. These new approaches require new operational capabilities, and this ... team is responsible for identifying those gaps, building requirements to drive the development of new capabilities, and tying them to Highmark's strategic capability roadmap. They will need to work effectively across teams to inform and influence change to… more
- Cardinal Health (Lansing, MI)
- …need for a better quality of life. Our diverse expertise in pharma, payer and hub services allows us to deliver best-in-class solutions-driving brand and patient ... markers of success. We're continuously integrating advanced and emerging technologies to streamline patient onboarding, qualification and adherence. Our non-commercial specialty pharmacy is centralized at our custom-designed facility outside of Dallas, Texas,… more
- R1 RCM (Detroit, MI)
- …of the top 100 US health systems, and handles over 270 million payer transactions annually. This scale provides unmatched operational insight to help healthcare ... organizations unlock greater long-term value. To learn more, visit: https://www.r1rcm.com . more