- Molina Healthcare (Detroit, MI)
- …compliance by owning Molina's entire CMS Complaints Tracking Module (CTM) life cycle. As Director of CTM Oversight & Resolution you set the standards and ... related field (advanced degree a plus). **Experience** * 7+ years managing Medicare CTM, appeals & grievances, or related compliance functions-hands-on with CMS CTM… more
- Molina Healthcare (Detroit, MI)
- …and regulations, contract provisions, and internal policies and procedures. * Supports the Operational Oversight Manager, Director , and team in the general ... reporting exists to demonstrate compliance to regulatory requirements. * Supports Manager and Director with developing the Operational Oversight Work Plan,… more
- Molina Healthcare (Detroit, MI)
- **Job Description** **Job Summary** Leads and directs Molina Medicare segment leaders who are responsible for the development and administration of Medicare ... **Job Duties** + Enable market P&L success through support and oversight for assigned markets, including D-SNP market performance management. + Function… more
- Molina Healthcare (Detroit, MI)
- …abilities; ability to handle multiple priorities and deal with ambiguity; provide oversight over the strategic and operational portfolios; manage strategic ... Program Management professional. Responsible for overall governance across all operational and strategic portfolio of projects; strong management and leadership… more
- Molina Healthcare (Detroit, MI)
- …on increased responsibility and adding value to the organization + Ensures strong operational processes are in place to deliver across all areas of responsibility + ... Provides oversight analyses of demographic data to support accurate Network Adequacy Reporting and Directory development. + Manage multiple resources and projects… more
- Molina Healthcare (Detroit, MI)
- …Encounters is responsible for establishing enterprise-wide strategy, governance, and oversight of processes that track, evaluate, and submit encounter deletions ... for Medicare Advantage, ACA, and Medicaid lines of business. This...accuracy & completeness (ie, Encounter Production, Audit, Production Vendor Oversight ) for assigned lines of business. Responsible for increasing… more
- Integra Partners (Troy, MI)
- …Management (UM) Nurse Supervisor is responsible for providing direct leadership and oversight to the UM nursing team. This role ensures team performance, ... with organizational, state, and federal requirements. The Supervisor balances hands-on operational responsibilities with leadership duties, serving as both a mentor… more
- Henry Ford Health System (Troy, MI)
- …group tasked with implementing system-wide improvements within multi-disciplinary operational teams, ensuring optimal and compliant Mid-Revenue Cycle processes ... within value-based reimbursement models and initiatives. Reporting to the Director , Risk Adjustment and Value-Based Payment, the Program Manager is responsible for… more