- Tenet Healthcare (Detroit, MI)
- …Supplies, and Staffing (MESS). Responsible for continuing self-education regarding payer requirements and third party regulations under limited guidance and ... assistance of department management. Maintains positive customer service at all times, refine and clarify referring unresolved issues to appropriate supervisor. Qualifications : 1. High school diploma, associate degree in related area preferred. 2. Three or… more
- BrightSpring Health Services (Southfield, MI)
- …safety regulations across all service settings. . Support external audits, payer reviews, licensing inspections, and accreditation site visits, preparing data and ... documentation as needed. . Partner with cross-functional leaders (Clinical, Operations, Facilities, HR) to ensure safety priorities are embedded across departments. . Data, Reporting & Leadership Communication . Create and present analytical and strategic… more
- Evolent (Lansing, MI)
- …Familiarity with healthcare claim processing **(Preferred)** + 5+ years experience at payer or management consulting firm **(Preferred)** + Basic knowledge of GAAP ... **(Preferred)** To ensure a secure hiring process we have implemented several identity verification steps, including submission of a government issued photo ID. We conduct identity verification during interviews, and final interviews may require onsite… more
- University of Michigan (Ann Arbor, MI)
- …information. + Coordinate clinical services provided to patients according to payer guidelines (eg, routing of lab specimens, ordering durable medical equipment). ... + Develop and recommend changes in patient care activities to improve the quality of patient care services. + Process patient care orders using the electronic ordering system may be required in certain areas. + Perform other related duties as assigned.… 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
- Gentiva (Okemos, MI)
- …sources, and the care team * Assist with referrals, regulatory documentation, and payer compliance * Travel to various Gentiva hospice locations as assigned to fill ... urgent needs **Schedule & Travel:** This role typically follows a Monday-Friday schedule, with occasional on-call responsibilities. Travel is required and may include: + Option 1: Overnight travel required to cities within a 100-mile radius. + Option 2:… more
- Centene Corporation (Lansing, MI)
- …management activities to ensure compliance with current state, federal, and third-party payer regulators + Provides and/or facilitates education to members and their ... families/caregivers on disease processes, resolving care gaps, healthcare provider instructions, care options, referrals, and healthcare benefits + Provides feedback to leadership on opportunities to improve and enhance care and quality delivery for members in… 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
- Highmark Health (Lansing, MI)
- …combination of experience and education **Preferred** + 6 years of experience in payer , hospital system, or care delivery industry + Experience with hospital M&A + ... Experience influencing change in complex organizational systems **SKILLS** + Ability to solve complex conceptual and operational problems; potential ability to lead teams in problem-solving exercises + Strong quantitative and analytical skills + Demonstrated… more
- Henry Ford Health System (Detroit, MI)
- …review/case management documentation systems. + Knowledge of CMS, commercial payer requirements, and hospital financial/reimbursement processes is desirable. + ... Demonstrated ability to think critically, solve problems creatively, and plan effectively. + Self-direction, flexibility, and the ability to work in a fast-paced environment. Licenses and Certifications: + Registered Nurse (RN) with a valid, unrestricted State… more