- CenterWell (Lansing, MI)
- **Become a part of our caring community and help us put health first** The Medical Director , Primary Care relies on medical background and reviews health ... claims. The Medical Director , Primary Care work assignments involve moderately complex to...internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and Medicare Advantage requirements… more
- Humana (Lansing, MI)
- **Become a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The ... Medical Director work assignments involve moderately complex to complex issues...internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and Medicare Advantage requirements,… more
- Humana (Lansing, MI)
- …Become a part of our caring community and help us put health first The Medical Director actively uses their medical background, experience, and judgement to ... and will understand how to operationalize this knowledge in their daily work. The Medical Director 's work includes reviewing of all submitted medical … more
- University of Michigan (Ann Arbor, MI)
- CLINICAL NURSING DIRECTOR (CS Mott Children's Hospital: 10-West Pediatric Cardiothoracic Intensive Care Unit- PCTU) Apply Now **Job Summary** The Pediatric ... from state, regional, national, and international referrals. PCTU specializes in the medical and surgical care of infants, children, adolescents, and adults with… more
- Molina Healthcare (Detroit, MI)
- JOB DESCRIPTION Job Summary Provides medical oversight and expertise in appropriateness and medical necessity of services provided to members, targeting ... and cost-effective member care. Essential Job Duties * Determines appropriateness and medical necessity of health care services provided to plan members. * Supports… more
- Integra Partners (Troy, MI)
- The UM Coordinator assists and supports the clinical team ( UM Nurses/ Medical Director ) with administrative and non-clinical tasks related to processing ... authorization platform + Initiate appeal cases and forward to UM Nurses for completion + Meet internal ...& external sources + Other duties as assigned by UM Director + Strong organizational skills, ability… more
- Integra Partners (Troy, MI)
- …policies). + Review and process clinical and administrative appeals; coordinate with Medical Director when required. + Generate and review daily/weekly reporting ... Quality) to resolve escalations and address utilization management issues. + Represent UM nursing team in internal meetings and external stakeholder interactions… more
- University of Michigan (Ann Arbor, MI)
- …**SUPERVISION RECEIVED** General supervision is received from Administrative Manager, Medical Director or Nurse Manager. **PHYSICAL REQUIREMENTS** This ... Medical Assistant Associate/Assistant ( Internal Applicants Only)...Time** Full-Time **Regular/Temporary** Regular **FLSA Status** Nonexempt **Organizational Group** Um Hospital **Department** MM CVC Clinic **Posting Begin/End Date**… more
- Corewell Health (Grand Rapids, MI)
- …Priority Health - 1231 E Beltline - Grand Rapids Department Name PH - Executive Medical Director Employment Type Full time Shift Day (United States of America) ... trend and cost of care, potentially including partnering with the care delivery system ( internal and external) on UM /CM best practices and shared operations. +… more
- University of Michigan (Ann Arbor, MI)
- …care complexes in the world and has been the site of many groundbreaking medical and technological advancements since the opening of the U-M Medical School ... $1.00 / hour The benefit package includes: + Excellent medical , dental and vision coverage + 2:1 Match on...resources available within the Ambulatory Care and Department of Internal Medicine/hepatology transplant settings to determine and meet the… more
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