- Henry Ford Health System (Troy, MI)
- GENERAL SUMMARY: Responsible for handling of daily pharmacy duties such as drug claim adjudication issues, prior authorization, and pharmacy benefit inquiries ... and external individuals. Subject matter expert in the resolution of pharmacy benefit coverage issues and coordinating prior authorization and exception processes.… more
- Henry Ford Health System (Troy, MI)
- …for the prompt and thorough investigation of medical, transportation, and pharmacy member appeals and grievances for Health Alliance Plan's (HAP's): Commercial, ... Medicare Advantage, Medicare-Medicaid Program (MMP), and Medicaid lines of business. Analyst must identify trending issues on an ongoing basis and provide root/cause… more
- WTW (Detroit, MI)
- …OH, Cincinnati OH, Cleveland, OH, Pittsburgh, PA As a Healthcare Financial/Actuarial Analyst you will support a wide variety of projects involving the design, ... funding, and measurement and financial analysis of the full spectrum of employer health and welfare benefit programs including medical, dental, life, disability,… more