- Integra Partners (Troy, MI)
- The Project Manager - Healthcare Claims Management (Subject Matter Expert) is responsible for leading complex projects and initiatives related to ... improvements. This role requires deep subject matter expertise in healthcare claims systems, workflows, and regulatory requirements.... management, with at least 3 years in a project management capacity. + Deep knowledge of claims… more
- Molina Healthcare (Sterling Heights, MI)
- …keeping, performance coaching, development, and career paths. + Daily management of Healthcare Analytics team. + Allocate new report/ project requests (workload ... their projects, maintains internal work plans as well as project work plans to meet reporting needs of the...leadership experience + 10 years' work experience preferable in claims processing environment and/or healthcare environment +… more
- Molina Healthcare (Warren, MI)
- …EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES:** * 7+ years experience in managed healthcare Quality/HEDIS project management and HEDIS Audit * Demonstrated ... Improvement function oversees, plans, and implements new and existing healthcare quality improvement initiatives and education programs; ensures maintenance of… more
- Molina Healthcare (MI)
- …trends, payment integrity issues, and process gaps. + Applies understanding of healthcare regulations, managed care claims workflows, and provider reimbursement ... operational initiatives tied to Payment Integrity (PI) and provider claims accuracy. The individual will be relied upon to...years of experience as a Business Analyst or Program Manager in a Managed Care Organization (MCO) or health… more
- Molina Healthcare (MI)
- …recommendations for improvement to decision-makers. At the direction of the Manager , Encounters, collaborates with cross-functional teams to identify and resolve ... rejection inventory, and works with other areas including IT, health plan, claims , provider, enrollment, regulators, and external vendors, as needed, to remediate… more
- GovCIO (Lansing, MI)
- …Skills and Experience** + Experience working with the Department of Veterans' Affairs + Healthcare Claims X.12 Transaction (837, 835, 277, etc.), Healthcare ... **Overview** GovCIO is currently hiring for a Test Manager tooversee the testing strategy, planning, and execution across a portfolio of healthcare systems,… more
- Otsuka America Pharmaceutical Inc. (Lansing, MI)
- … project management, quality assurance, etc.) in pharmaceutical or healthcare related industry. Experience with FDA or other health authority interactions ... associated regulatory challenges to the GRL, global regulatory team, assigned project teams, and internal/external functional business units as needed. Works… more
- Humana (Lansing, MI)
- …JD, MSN, Clinical Certifications, CPC, CCS, CFE, AHFI) + Understanding of healthcare industry, claims processing and internal investigative process development + ... help us put health first** The Special Investigations Unit Manager leads and monitors investigations of allegations of fraudulent...Bachelor's Degree + Minimum of 3 yrs health insurance claims or Medicare experience + Minimum 3 years of… more
- Molina Healthcare (Grand Rapids, MI)
- …provisions, and internal policies and procedures. * Supports the Operational Oversight Manager , Director, and team in the general development of the Operational ... reporting exists to demonstrate compliance to regulatory requirements. * Supports Manager and Director with developing the Operational Oversight Work Plan,… more
- Amgen (Detroit, MI)
- …us and transform the lives of patients while transforming your career. **Field Reimbursement Manager - Detroit, MI** **What you will do** Let's do this. Let's change ... the world. In this vital role the Field Reimbursement Manager (FRM) will manage defined accounts within a specified...any issues or coverage challenges + Educate and update healthcare providers (HCPs) on key private and public payer… more