- Integra Partners (Troy, MI)
- …and representing Integra's clinical position to internal and external stakeholders. The Senior Utilization Review Medical Director's responsibilities ... require. The Senior MD provides clinical oversight to the Utilization Review Medical Director(s), ensures consistent application of criteria, leads … more
- CenterWell (Lansing, MI)
- …will collaborate with other health care givers in reviewing actual and proposed medical care and services against established CMS Coverage Guidelines/NCQA review ... Prior clinical experience, managed care experience, DME, Florida Medicaid **OR** utilization management experience + Demonstrates Emotional Maturity + Ability to… more
- Highmark Health (Lansing, MI)
- …the gap between business needs and the analytical technology team. The Senior Decision Support Consultant will leverage technical, analytical, and business expertise ... of developing technical solutions. The consultant will act as a senior resource within the team, fostering business-to-technical collaboration and providing… more
- Ryder System (Highland Park, MI)
- _Job Seekers can review the Job Applicant Privacy Policy by clicking here (http://ryder.com/job-applicant-privacy-policy) ._ **Job Description** : BUILD ON YOUR ... is an essential industry and we've been in the game since 1933! The Senior Ops Manager manages the operations and personnel for locations with approximately _430_… more
- Coinbase (Lansing, MI)
- …analysis, risk assessments, development of the audit plan, project management, quality review , report issuance and issue validation across IT and business functions. ... clear findings, risk implications, and pragmatic, actionable recommendations to senior management and relevant stakeholders. Partner with leadership to develop… more
- Humana (Lansing, MI)
- …community and help us put health first** Humana Healthy Horizons is seeking a Senior Medicaid Provider Education Professional for active markets who will serve as a ... role is responsible for assisting in the development, updating, and annual review of provider education materials to ensure a best-in-class provider experience for… more
- Molina Healthcare (Grand Rapids, MI)
- …research, financial modeling, and analysis of complex healthcare claims data ( medical , pharmacy and ancillary) to deliver practical, actionable financial and even ... skills required to present analytical results and findings to healthplans' senior management team and key stakeholder meetings (PowerPoint) * Coordinates and… more
- Molina Healthcare (Warren, MI)
- …research, financial modeling, and analysis of complex healthcare claims data ( medical , pharmacy and ancillary) to deliver practical, actionable financial and even ... skills required to present analytical results and findings to health plans' senior management team and key stakeholder meetings (PowerPoint) + Coordinates and… more
- Molina Healthcare (Grand Rapids, MI)
- …requestors to ensure appropriate creation of reports and analyses. Uses peer-to-peer review process and end-user consultation to reduce report writing errors and ... and other statistical methodologies to predict future trends in cost, utilization and performance. Provide executive summary of findings to requestors. +… more
- Oracle (Lansing, MI)
- …Oracle Cloud Infrastructure (OCI) is seeking a technically advanced and hands-on Senior Software Engineer to drive the design, implementation, and optimization of ... Troubleshooting: Use advanced diagnostic tools to analyze protocol behavior, buffer utilization , network bottlenecks, and implement corrective actions at scale. +… more