- AmeriHealth Caritas (Detroit, MI)
- **Role Overview:** ;The Provider Network Operations Data Analyst plays a key role in maintaining accurate provider data and fostering strong ... procedures, and regulatory updates clearly and professionally. + Maintain and monitor provider data to ensure accuracy across all systems. + Review and process … more
- Meta (Lansing, MI)
- …business risk, our team is accountable. We provide the services to manage network operations across data center, backbone, subsea, and edge locations; ... in code 7. Data Measurement: As an operations practitioner supporting our network , you will...performance issues into improvement plans with enterprise and service provider vendors such as network hardware platforms(Cisco,… more
- Molina Healthcare (Warren, MI)
- …Information process functions. + Partner with stakeholders to creatively design solutions utilizing provider data such as the Provider Online Directory, ... **Job Description** **Job Summary** The Network Solutions Director is responsible for leading a...combination of education and experience **Required Experience** 7-9 years Provider Data **Preferred Education** Graduate Degree or… more
- Corewell Health (Grand Rapids, MI)
- …must be analyzed and reviewed with the cooperation of the provider network community and internal departments. The operations analyst is responsible for the ... Job Summary A Provider Operations Associate is responsible for...specific data for CMS service area expansion, network adequacy reporting and Medicaid Provider reporting.… more
- Molina Healthcare (Detroit, MI)
- … Information process functions. * Directs the development, implementation and maintenance of provider data in the claims payment system. * Supports critical ... critical provider information on all claims and provider databases. Synchronizes data among multiple claims...and implementing appropriate Corrective Action Plans for submission of provider network files, etc. * Engages with… more
- Humana (Southfield, MI)
- …orientations and onboarding, managing and responding to escalated issues for network providers, conducting ongoing education including provider training, ... to resolution. + Understanding of health insurance claims and ability to analyze data to resolve provider service issues. + Excellent written and verbal… more
- Meijer (Grand Rapids, MI)
- …the job profile below and apply today! Meijer is seeking an experienced Senior Network Operations Engineer with broad experience of network technologies. The ... upgrade and migration projects ensuring minimal disruption to business operations . + Document network architecture, configurations, inventory and changes… more
- CVS Health (Lansing, MI)
- …lives.**_** The Provider Experience, Interoperability, Digital Solutions & Provider Operations organization provides foundational operational / enabling ... experience in one or more of the following areas: provider revenue cycle operations / optimization, payer...(EDI), practice management software, etc. + Prior experience with Provider Network functions / processes and market… more
- Evolent (Lansing, MI)
- …Account teams and payer clients to align priorities and deliver high-quality provider network engagement, performance reporting, and present to health plans ... value-based care frameworks, and thrives at the intersection of clinical quality, operations , and strategic provider collaboration. This leadership role is… more
- Humana (Lansing, MI)
- …role is within the Integrated Pricing Solutions (IPS) department which falls under the Provider Process and Network Organization (PPNO). **The Sr. Provider ... help us put health first** The Sr. Medicare (PPS) Provider Hospital Reimbursement Analyst will be an integral part...with IT, the pricing software vendor, CIS BSS, claims operations , and other business teams involved in the administration… more