- McLaren Health Care (Flint, MI)
- …or other health care setting. **Preferred:** + One (1) year Managed Care Utilization review experience. + Experience and knowledge of the preauthorization ... We are looking for a Intake Specialist , to join us in leading our organization...at the most appropriate and cost-effective setting. Monitors members' utilization patterns for identification of high-risk and under and… more
- Corewell Health (Grand Rapids, MI)
- …or events. We are seeking a highly skilled and detail-oriented RN Clinical Database Specialist to join our team with a primary focus on managing and optimizing data ... Also ensures continuity and coordination of services with appropriate utilization of resources. Responsible for stakeholder management across collaboration within… more
- Kuehne+Nagel (Detroit, MI)
- …our Detroit site is looking for a new Sea Logistics Operational Care Specialist , Export to join our Sea Logistics team. **How you create impact** Reporting ... to clients within the period established. + You will review the Gross Profit and confirm accuracy. + Ensure...Collaborate with the system process team to drive automation utilization related to Operational Careprocesses. + Constantly challenge the… more
- Cognizant (Lansing, MI)
- …experience. * Experience in the analysis and processing of claims for payments, utilization review /quality assurance procedures. * Must be able to work with ... is required. **Travel:** None required **About the role:** As Claims Adjudication Specialist , you will be responsible for timely and accurate adjudication of… more
- Corewell Health (Grand Rapids, MI)
- …programs to ensure objectives are achieved. + Responsible for the analysis, review and dissemination of network performance information, including but not limited to ... financial, quality, utilization /satisfaction and/or disease specific. + Develops and delivers or...BSN. + Certified Professional Coder CPC or Certified Coding Specialist CCS + Project Management Professional PMP certification +… more
- Trinity Health (Howell, MI)
- …(pre-certifications, third-party authorizations, referrals) and contacts physicians and Case Management/ Utilization Review personnel, as needed. Obtains and ... and skills competencies such as the Certified Revenue Cycle Specialist Professional (CRCSP) through the American Association of Healthcare Administrative… more
- Coinbase (Lansing, MI)
- …it, tackling problems head-on. We are looking for a Talent Process Specialist to drive process design, optimization, and technology enablement across the ... marketing teams to create content that will drive CRM utilization and engagement. * Stay ahead of industry trends...and engages in dynamic conversation. A human recruiter will review your interview responses, provided in the form of… more
- SpartanNash (Wyoming, MI)
- …by the Company. + Generate various reports (ie store sales, prescription drug utilization , inventory, etc.) and review with pharmacy operations to assist stores ... Summary:** This role is responsible to participate in the review and compliance of pharmacy operations and provide training...personnel. **Here's what you'll do:** + Participate in the review and compliance of pharmacy operations. + Conduct store… more
- Veterans Affairs, Veterans Health Administration (Wyoming, MI)
- …both orally and in writing as assigned. Monitoring will include prospective review and intervention in: 1. Therapeutic appropriateness of a patient's drug regimen ... care professionals, patients and caregivers. vii. Participates in multidisciplinary review of patients, reviews charts, evaluates pertinent laboratory data,… more
- Mondelez International (Farmington, MI)
- …management, pallets management. **How you will contribute** You will: + Review and analyze stock inaccuracies and guarantee accurate stock alignment between ... based on available information among stakeholders. Analyze and verify capacity utilization , performance and KPI monitoring, and introduce corrective measures in case… more