- Humana (Lansing, MI)
- …understanding of how organization capabilities interrelate across segments and/or enterprise-wide. ** Regional VP of Health Services, Humana Medicare Advantage** ... and Medicare Advantage goals. **Primary Responsibilities:** Clinical Engagement & Provider Strategy: + Cultivate and maintain trusted relationships with CMOs and… more
- Humana (Lansing, MI)
- …Staff + Works closely with internal stakeholders including Finance, Actuarial, Clinical, Medicare Risk Adjustment, Provider Contracting , and Provider ... Vice President of Operations in support of the Medicare Advantage line of business. The Market Finance Lead...and leaders, as well as some visibility to external provider partners + Advises regional leadership of… more
- Molina Healthcare (Grand Rapids, MI)
- …management policies and procedures to improve quality outcomes and decrease costs. * Provide regional medical necessity reviews and cross coverage * Standardizes ... Medicare . **Preferred Experience** * Peer Review, medical policy/procedure development, provider contracting experience. * Experience with NCQA, HEDIS,… more