- Humana (Lansing, MI)
- …our caring community and help us put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business ... the Pricer Business and System Support team responsible for administering complex Medicaid provider reimbursement methodologies. The associate will support… more
- Humana (Lansing, MI)
- …part of our caring community and help us put health first** The Medicare (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business ... Pricer Business and System Support team responsible for administering complex Medicare provider reimbursement methodologies. The business needs of the team… more
- Molina Healthcare (MI)
- …* Working experience with, and strong knowledge of, various managed healthcare provider compensation and VBP methodologies, primarily across Medicaid and ... live in Georgia _** **Job Description** **Job Summary** Molina Health Plan Provider Network Contracting jobs are responsible for the network strategy and development… more
- Molina Healthcare (Sterling Heights, MI)
- …* Clearly and professionally communicates contract terms, payment structures, and reimbursement rates to physician, hospital and ancillary providers. * ... contract negotiations in a managed healthcare setting ideally in negotiating different provider contract types, ie physician, group and hospital contracting,… more
- Humana (Lansing, MI)
- … Provider Contracting Professional 2 initiates, negotiates, and executes physician, hospital , and/or other provider contracts and agreements. The Provider ... years of experience servicing or negotiating managed care contracts with physician, hospital and/or other provider contracts + Proficiency in analyzing,… more
- AmeriHealth Caritas (Detroit, MI)
- …contracts that align with company standards and regulatory requirements. + Ensure provider contracts comply with pricing methodologies, Medicaid fee schedules, ... & Contracting** + Lead the development and management of hospital and physician networks across current and expansion markets....or healthcare setting. + 3 to 5 years of provider contracting and reimbursement experience. + 3… more
- Humana (Lansing, MI)
- …Senior Provider Contracting Professional initiates, negotiates, and executes physician, hospital , and/or other provider contracts and agreements for an ... + 2+ years of network management experience including but not limited to: provider and hospital contracting, network administration in a healthcare company or… more
- Henry Ford Health System (Detroit, MI)
- …financial audits. + Maintain deep expertise in Medicare, Blue Cross, Medicaid , and other reimbursement regulations, ensuring organizational compliance. + ... academic and integrated health systems, is seeking a Director of Corporate Reimbursement to lead critical financial functions that directly impact the organization's… more
- Henry Ford Health System (Troy, MI)
- …of underpayment recovery strategies and systems designed to facilitate and maximize reimbursement for HFHS hospitals, provider , and ambulatory revenue cycle ... or seven (7) or more years of experience in Hospital or Professional Billing, Contracting, Payment Variances, or other...a Healthcare or Business setting. + Knowledge of Medicare, Medicaid , Medicaid OPPS reimbursement , and… more
- Humana (Lansing, MI)
- …coding auditor to review inpatient hospital claims for proper reimbursement , handle provider disputes in a result-oriented and metrics-driven environment. ... Coding Auditor contributes to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, and by ensuring correct claims… more