- CVS Health (Lansing, MI)
- …all with heart, each and every day. **Position Summary** As the Manger of Business Compliance of Quality Review, Training, and Program Integrity, you will lead ... development of team members, managing quality review processes, and ensuring compliance with state regulations and contractual requirements. _Flexible on location… more
- CVS Health (Lansing, MI)
- …strategic initiatives, along with a team of medical coders/nurses supporting Aetna 's Special Investigations Unit. Key Responsibilities: + Leadership: Leads a team ... distribution and exposure to wide range of reviews. Assist with business opportunities aligned to inventory allocation and prioritization. + Quality Control… more
- CVS Health (Lansing, MI)
- …And we do it all with heart, each and every day. **Position Summary** The Aetna Pharmacy Health Plan Compliance team is seeking an experienced professional with ... pharmacy programs and benefit plans, to identify and track business and compliance risks and issues and...to become compliant. Our team collaborates with both the Aetna Health Plan business teams and with… more
- CVS Health (Lansing, MI)
- …Manage Third Party Risk Governance process for your assigned TPA(s). + Manage ongoing Aetna compliance review process for your assigned TPA(s). + Manage monthly ... manages competitive and complex contractual relationships with TPAs and/or business partners in Europe, APAC, Africa and Middle East...TPA networks are timely reviewed and uploaded on internal Aetna systems. + Ensure TPA guides, country guides and… more
- CVS Health (Lansing, MI)
- …preferred -Certified Case Manager preferred **Education** -Associates required, BSN preferred ** Business Overview** At Aetna , a CVS Health company, we are ... it all with heart, each and every day. **Case Manager RN** WFH Flexible **Position Summary** Help us elevate...This is a work from home position. Schedule: Standard business hours - 8:00AM-5:00PM, no night, weekend or holiday… more
- CVS Health (Lansing, MI)
- …to 25 % - 50% travel in Wayne and Macomb County, MI. Schedule: Standard business hours - 8:00AM-5:00PM, no night, weekend or holiday shifts! **There is potential of ... patient care to a whole new level! Join our Aetna team as an industry leader in serving dual...interdisciplinary case conferences + Utilizes case management processes in compliance with regulatory and company policies and procedures. +… more