- CVS Health (Lansing, MI)
- …initiatives/programs and completes State/HSAG PIP templates for submission. + Assists Senior Quality Manager and Director with coordination and implementation of ... 5+ years clinical and/or managed care experience in the healthcare industry and quality management preferred. + 3-5 years of Project Management experience.… more
- Prime Therapeutics (Lansing, MI)
- …Come build the future of pharmacy with us. **Job Posting Title** Georgia Medicaid Clinical Account Manager - Remote **Job Description** Innovative business ... residency sponsorship **Additional Qualifications** + 3-5 years' experience in clinical operations, quality , network, pharmacy or project management OR a managed… more
- Prime Therapeutics (Lansing, MI)
- …terms of scope, quality , budget, issue/risk management and schedule. The Senior Project Manager will provide strong technical experience to the approach of ... pharmacy with us. **Job Posting Title** North Carolina Senior Project Manager / Operations Lead - Remote...responsible for orchestrating all activities for the North Carolina Medicaid PBM account implementation and projects throughout the life… more
- Humana (Lansing, MI)
- …a part of our caring community and help us put health first** As a Senior Project Manager for Risk Adjustment Strategy and Business Support, you will manage all ... project , from start to finish. The Senior Project Manager work assignments involve moderately complex...need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid… more
- Humana (Lansing, MI)
- …they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid , families, individuals, military service ... understands that while great products are important, it's the quality of our service that truly defines us. We...and self-driven individuals to join our team. Our Senior Manager , Medicare Sales, motivates and drives a team of… more
- CVS Health (Lansing, MI)
- …actionable insights to support fraud, waste, and abuse (FWA) detection and Medicaid regulatory & compliance reporting. This is an individual contributor role. Job ... data analyses to support investigations of potential fraud, waste, and abuse in Medicaid claims and provider activity. + Prepare timely and accurate Medicaid … more
- CenterWell (Lansing, MI)
- …of clinical questions related to authorization determinations. * Collaborate with Quality , Compliance, and Audit teams to support medical reviews and audits. ... **Compliance & Risk Management** * Ensure compliance with Medicare, Medicaid , and commercial payer authorization and revalidation requirements. * Maintain… more
- Datavant (Lansing, MI)
- …is focused on ensuring the work we do for our customers is of the highest quality and yields positive outcomes. To achieve this, you will leverage a wide array of ... and insights about coding output to enhance productivity and quality , and turn those needs into actionable reporting +...+ Run various risk adjustment models for Medicare Advantage, Medicaid or ACA to forecast patient risk scores and… more