- Henry Ford Health System (Troy, MI)
- …skills. + Strong organizational and interpersonal skills. + Strong Understanding of Managed Care Reimbursement methodologies, coding, and terminology. ... EDUCATION/EXPERIENCE REQUIRED: + Bachelor's degree in Finance, Accounting, Business Administration, Managed Care Contracting, Reimbursement , or related… more
- Henry Ford Health System (Troy, MI)
- …Experience in reimbursement and/or data analytics preferred. * Knowledge of managed care organizations and integrated health systems. * Comprehensive project ... GENERAL SUMMARY: Reporting to the Director - Managed Care Contracting, this position is...Care Contracting team in evaluating, analyzing, and negotiating contract terms and reimbursement rates with health… more
- AmeriHealth Caritas (Southfield, MI)
- … language for resolution. + Demonstrates a functional knowledge of provider data and managed care provider reimbursement methodologies. + Knowledge of ... to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and...services throughout the Plan's territory in keeping with State contract mandates. + Responsible for provider data management +… more
- Molina Healthcare (Detroit, MI)
- …in health care field including, but not limited to, provider's office, managed care , or other health care field. **REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS ... contracting with large specialty or multispecialty provider groups. * 1-3 Years Managed Care experience **PREFERRED EXPERIENCE** : Knowledge of integrated… more
- Trinity Health (Livonia, MI)
- …will be considered. In-depth knowledge and experience of analysis and reporting regarding health care costs within a managed care organization. This should ... pay for performance programs. This includes all analytics pertaining to payer contract modeling and performance for all provider types including acute inpatient and… more
- R1 RCM (Detroit, MI)
- …will represent healthcare providers in their disputes with medical insurance carriers and managed care organizations at all stages of the administrative appeals ... process. Every day, you will handle contract review and appeal template development based on contractual...you must maintain a foundational understanding of Commercial, Governmental, Managed Care , and ERISA regulations regarding payment,… more
- Ford Motor Company (Dearborn, MI)
- …key department documents (Supplier Guide, DRIM); ensuring compliance with contract standards; staying abreast of and disseminating corporate policy changes ... Production PBO. + **Contracts:** + Develop and implement a comprehensive contract management system to ensure all contracts (MYAs, bailments, insurance agreements,… more
- Trinity Health (Livonia, MI)
- …systems such as ICD-10, SNOMED CT and LOINC. + Provides subject matter expertise to managed care colleagues to improve contract language to reduce pre- and ... deed. Strong understanding of the Catholic health ministry in an evolving health care delivery system and changing reimbursement market. Strong analytical skills… more
- Centene Corporation (Detroit, MI)
- …degree with 5+ years of relevant experience. Previous experience in a managed care organization strongly preferred. 3+ of leadership experience. Master's ... regulators for clinical programs*Coordinates quality initiatives (audits, star ratings, contract reviews, etc) and activate enterprise and local policies*Informs and… more
- R1 RCM (Detroit, MI)
- …and effectively with key stakeholders and upper management + Analyze clients' managed care contracts and government-based fee schedules to identify underpayments ... + Understand and articulate claim and contract details to facilitate proper billing and ...only does that drive customer success and improve patient care , but that same enthusiasm is applied to giving… more
- R1 RCM (Detroit, MI)
- …key internal and external stakeholders and upper management + Analyze clients' managed care contracts and government-based fee schedules to identify ... future revenue loss + Understand and articulate claim and contract details to facilitate proper billing and reimbursement...only does that drive customer success and improve patient care , but that same enthusiasm is applied to giving… more