- Molina Healthcare (Grand Rapids, MI)
- **JOB DESCRIPTION** **Job Summary** JOB SUMMARY: The Sr. Analyst , Healthcare plays a critical role in supporting clinical and operational initiatives by translating ... advanced SQL queries to extract, validate, and analyze healthcare data, including claims, pharmacy , and lab datasets. + Build and maintain efficient ETL pipelines to… more
- Prime Therapeutics (Lansing, MI)
- …passion and drives every decision we make. **Job Posting Title** Compliance Analyst Principal (Performance and Oversight) - Remote **Job Description** The Compliance ... experience in legal or compliance related roles for a healthcare or Pharmacy Benefit Management organization, or within a highly regulated industry, including… more
- Prime Therapeutics (Lansing, MI)
- …passion and drives every decision we make. **Job Posting Title** Compliance Analyst Principal - Remote **Job Description** The Compliance Principal is responsible ... experience in legal or compliance related roles for a healthcare or Pharmacy Benefit Management organization, or within a highly regulated industry, including… more
- Highmark Health (Lansing, MI)
- …computer applications to include MS Excel and/or MS Access **Preferred** + Prior pharmacy experience with a pharmacy benefit manager (PBM), consultant, ... pharmacy provider, or another organization specializing in pharmacy **LICENSES or CERTIFICATIONS** **Required** + None **Preferred** + None **SKILLS** + Strong… more
- WTW (Detroit, MI)
- …specialty consulting services including clinical/health management program design, pharmacy solutions, disability/absence management strategies and claims audit ... services. Product-based solutions such as our pharmacy purchasing coalition round out our broad-based suite of...etc. + Gain specialized knowledge in areas such as pharmacy , life and disability insurance, health equity and wellbeing,… more
- CVS Health (Lansing, MI)
- …seeking an experienced Senior Healthcare Fraud Investigator to join our Dental/ Pharmacy /Broker Investigative Team within Aetna's Special Investigations Unit. In this ... AHFI, CFE + Bilingual English/Spanish + Dental Investigative experience + Pharmacy Investigative experience + Marketplace Broker Investigative experience + Medicaid… more
- Corewell Health (Grand Rapids, MI)
- …all types of health care fraud including member, employer group, agent, pharmacy , provider, etc. Investigates, collects and documents findings for management review. ... related to abusive and fraudulent practices related to hospital, physician, pharmacist pharmacy , employer group, agent or other fraudulent entity. + 2 years of… more
- Highmark Health (Lansing, MI)
- …Nursing, Economics, Health Sciences, Informatics, Biostatistics, Statistics, Epidemiology or Pharmacy or closely related field **Substitutions** + None **Preferred** ... Health, Nursing, Economics, Health Sciences, Informatics, Biostatistics, Statistics, Epidemiology, Pharmacy or related field **EXPERIENCE** **Required** + 5 years of… more
- Henry Ford Health System (Troy, MI)
- …care, health insurance, a full suite of home health offerings, virtual care, pharmacy , eye care and other health care retail. With former Ascension southeast ... Michigan and Flint region locations now part of our team, Henry Ford's care is available in 13 hospitals and hundreds of ambulatory care locations. Based in Detroit, Henry Ford is one of the nation's most respected academic medical centers and is leading the… more
- Molina Healthcare (MI)
- …**Job Summary** Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization and cost containment ... information. Evaluates, writes, and presents healthcare utilization and cost containment reports and makes recommendations based on relevant findings. **KNOWLEDGE/SKILLS/ABILITIES** + Develop ad-hoc reports using SQL programming, SQL Server Reporting Services… more