- CVS Health (Lansing, MI)
- …compassionate. And we do it all with heart, each and every day. **Position Summary** The Medicaid Provider Operations Support (MPOS) team will serve as ... through the designated Liaisons for each scope within MPOS. **Expectations of Medicaid Provider Operations Support :** + Provides guidance to all… more
- Humana (Lansing, MI)
- …+ Team representative and presenter for various Medicaid committee meetings (ex; operations , quality, etc.). + Support pilot and proof of concept contracts. ... community and help us put health first** The Procurement Lead; Medicaid generates and implements efficient sourcing and category management strategies. Manages… more
- Humana (Lansing, MI)
- …analyze, storage, and distribution. + Team representative and presenter for various Medicaid committee meetings (ex; operations , quality, etc.). + Partner with ... + Understands and explains procurement and supplier oversight processes to Medicaid markets and business areas contacts + Improve and document processes… more
- Molina Healthcare (Ann Arbor, MI)
- …subject matter expert on developing financial models to evaluate the impact of provider reimbursement changes + Provide data driven analytics to Finance, Claims, ... **JOB DESCRIPTION** **Job Summary** The Manager, Medical Economics provides support and consultation to the Health Plan and Finance team through analyzing key… more
- Humana (Lansing, MI)
- …monitors drug development pipeline, and medical literature, while providing clinical support for internal stakeholders. Utilizes broad understanding of managed care ... Fully Integrated Dual Eligible Special Needs Plan (FIDE-SNP) Michigan Medicare - Medicaid health plan. The individual leverages a broad understanding of managed care… more
- Molina Healthcare (MI)
- …other operational departments and functional business unit stakeholders to lead or support various Provider Contracting functions. This role primarily leads ... * Working experience with, and strong knowledge of, various managed healthcare provider compensation and VBP methodologies, primarily across Medicaid and… more
- AmeriHealth Caritas (Detroit, MI)
- **Role Overview:** The Manager of Provider Network Management oversees the day-to-day operations of the Network Management department, including staff ... align with company standards and regulatory requirements. + Ensure provider contracts comply with pricing methodologies, Medicaid ...of termination. + Modify and expand the network to support new products, clients, and service areas. + Serve… more
- Humana (Lansing, MI)
- …will be an integral part of the Pricer Business and System Support team responsible for administering complex Medicare provider reimbursement methodologies. ... Senior Business Intelligence Engineer will be primarily responsible for maintenance and support of Medicare outpatient provider reimbursement for hospitals and… more
- McLaren Health Care (Flint, MI)
- …routine communication with such groups, performing presentations, education and other activities to support the Plan's provider service goals. All duties are to ... the State of Indiana and Centers for Medicare and Medicaid Services to bring you the Hoosier Healthwise and...least two (2) years' experience in managed care claims operations or provider billing functions. + Valid… more
- Humana (Lansing, MI)
- …system failures, summarize complex telemetry data, and develop intelligent copilots to support Operations teams + Lead research and evaluation of cutting-edge ... to make an impact** **Key Responsibilities:** + Lead and provide direction for our Managed Service Provider ...Service Provider (MSP) + Lead Managed Service Provider in Operations for Azure, GCP and… more