- Henry Ford Health System (Jackson, MI)
- …comfort and quality of life. As the only local provider certified by both Medicare and The Joint Commission, we deliver affordable, high-quality care across a wide ... range of insurance plans including Medicare , Medicaid, and private options. GENERAL SUMMARY: The Physical...a full suite of home health offerings, virtual care, pharmacy , eye care and other health care retail. With… more
- Henry Ford Health System (Troy, MI)
- Responsible for assisting with all Salesforce initiatives for the Medicare Advantage line of business from the scoping phase through mapping and overall execution; ... requirements; serve as operational business unit SME for the Medicare sales Operations and Retention team; attend daily stand-up...a full suite of home health offerings, virtual care, pharmacy , eye care and other health care retail. With… more
- Henry Ford Health System (Jackson, MI)
- …comfort and quality of life. As the only local provider certified by both Medicare and The Joint Commission, we deliver affordable, high-quality care across a wide ... range of insurance plans including Medicare , Medicaid, and private options. GENERAL SUMMARY: Under the...a full suite of home health offerings, virtual care, pharmacy , eye care and other health care retail. With… 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. ... products offered, State and Federal laws related to fraud, waste or abuse, Medicare and Medicaid regulations, etc. + Ability to work effectively with minimal… more
- CenterWell (Lansing, MI)
- …3 or more years experience in a high-volume community or mail order pharmacy practice environment + Previous experience in utilization management + Education: BSN or ... a related field + Health Plan experience + Previous Medicare /Medicaid Experience a plus + Call center or triage...largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health… more
- Henry Ford Health System (Grand Blanc, MI)
- …but not limited to: Blue Cross, HMOs, PPOs, private insurance companies, Medicare , Medicaid, private pay patients. + Receive, record payments for hospital, medical ... care, health insurance, a full suite of home health offerings, virtual care, pharmacy , eye care and other health care retail. With former Ascension southeast… more
- Henry Ford Health System (Troy, MI)
- …of the InterQual(R) or Milliman Care Guidelines(R) criteria preferred. + Knowledge of Medicare , Medicaid and NCQA guidelines and use of CMS website for research ... care, health insurance, a full suite of home health offerings, virtual care, pharmacy , eye care and other health care retail. With former Ascension southeast… more
- Henry Ford Health System (Southfield, MI)
- …Experience with Facets NetworX Agreement Configuration preferred. + Experience with Medicare PPS Pricing Methodology preferred. + Experience with configuring Optum ... care, health insurance, a full suite of home health offerings, virtual care, pharmacy , eye care and other health care retail. With former Ascension southeast… more
- CenterWell (Lansing, MI)
- …services. Able to navigate healthcare options; care services post-acute offerings, Medicare coverage, billing issues, as well as accessing healthcare resources. + ... one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the… more
- Molina Healthcare (Ann Arbor, MI)
- …or equivalent experience (such as specialties in: surgical, Ob/Gyn, home health, pharmacy , etc.). + Experience demonstrating knowledge of ICD-9, CPT coding and HCPC. ... MCG, InterQual or other medically appropriate clinical guidelines, Medicaid, Medicare , CHIP and Marketplace, applicable State regulatory requirements, including the… more