- Elevance Health (Dearborn, MI)
- …within 50 miles one of our Pulse Point locations. The ** Provider Contract / Cost of Care Consultant** will provide analytical support to the Cost ... ** Provider Contract / Cost of Care Consultant**...or any combination of education and experience, which would provide an equivalent background. **Preferred skills, capabilities, and experiences:**… more
- Molina Healthcare (Sterling Heights, MI)
- …or other health care environment. * 3+ years experience in provider contract negotiations in a managed healthcare setting ideally in negotiating ... Provider Community that result in high quality, cost effective and marketable providers. Contract /Re-contracting with...5-7 years contract -related experience in the health care field including, but not limited to, provider… more
- Molina Healthcare (Sterling Heights, MI)
- …Duties** This role negotiates assigned contracts and letters of agreements with non-complex provider community that result in high quality, cost effective and ... of medical group/IPA and hospital contracting. * Identified as contract system lead by developing and maintaining provider...: Bachelor's Degree or equivalent work experience in health care field including, but not limited to, provider… more
- Henry Ford Health System (Troy, MI)
- …Managed Care Contracting team in evaluating, analyzing, and negotiating contract terms and reimbursement rates with health plans. PRINCIPLE DUTIES AND ... with industry standards and Henry Ford Health reimbursement guidelines and changes to cost structure. 5. Implement and execute Managed Care Contracting Playbook… more
- Trinity Health (Livonia, MI)
- …forecasting and provider profiling. 3.Develop and continually refine the health care cost analysis process. Oversee the development and organization of ... and pay for performance programs. This includes all analytics pertaining to payer contract modeling and performance for all provider types including acute… more
- Henry Ford Health System (Troy, MI)
- …evaluate healthcare data and create segmentation reports that include trend analysis ( cost , price, and utilization); comparisons provider groups and hospital ... demographics, evidence-based measures, Global RVUs, MARA risk scores, ACA markets, provider regions and product segments. Create dashboards, report packages and… more
- Henry Ford Health System (Detroit, MI)
- …to HFH for care . + Influence relationships to choose HFH as provider of healthcare services. + Responsible for marketing strategies that promote the HFH brand ... obtain medical tourist from government and private entities. Will provide direct assistance and support to the entire international...manage and follow through on issues related to patient care , outcomes, cost , policy changes and other… more
- Area Agency On Aging 1-b (Southfield, MI)
- …and program integrity activities. Ensures agency is adhering to the MI Choice contract and the Michigan Medicaid Provider Manual (MPM) requirements. Completes ... is responsible for providing comprehensive responses in compliance with contract , regulatory and accreditation requirements pertaining to various product lines… more
- Burns & McDonnell (Detroit, MI)
- …for managing the construction project safety, quality, schedule, cost control, contracts, subcontractors, suppliers, proposals, estimates, documentation turnover, ... the successful execution of a single or multiple projects simultaneously. + Provide direction and participate in project planning, scheduling, estimating, cost … more
- Planate Management Group LLC (Warren, MI)
- …facilities engineering services worldwide. Planate is a small business provider of planning, design, infrastructure management, technical consulting, engineering, ... quality control, and submittal reviews beyond the expertise of construction managers + Provide quality assurance for ongoing projects, and serve as a mentor to fewer… more
- Trinity Health (Livonia, MI)
- …improvement methods/tools. Possesses and utilizes expert skills in managing physician/ provider productivity, efficiency and cost management, demonstrating ... tactfully and objectively with full regard for the uniqueness of the health care environment. Shares accountability with other System Office and RHM leaders for… more
- Wayne State University (Detroit, MI)
- …success in a global society. Essential functions (job duties): JOB PURPOSE Provide planning on various university space planning and capital construction projects. ... schedule performance. Coordinate project design activities ensuring compliance with cost , schedule, and quality, while minimizing impact on university teaching… more
- Sedgwick (Detroit, MI)
- Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our ... benefits due, and manages action plan pursuant to the claim or client contract . + Manages subrogation of claims and negotiates settlements. + Communicates claim… more
- Sedgwick (Detroit, MI)
- Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our ... of examiners and technical staff for clients; to monitor colleagues' workloads, provide training, and monitor individual claim activities; to provide … more
- Trinity Health (Livonia, MI)
- …who are poor, justice, stewardship, and integrity, our organization will continue to provide better health, better care , at lower costs. **ESSENTIAL FUNCTIONS** ... day-to-day operational supervision for local hospital and/or Medical Group Provider Services (MGPS) revenue integrity functions. Responsible for motivating staff… more
- Area Agency On Aging 1-b (Southfield, MI)
- …(SC) uses person-centered principals to perform comprehensive assessments to determine health care , social needs of applicants, and eligibility for the MI Choice ... Coordinates support services to assist participants in developing a person-centered long-term care (LTC) plan. The SC may be expected to cover multiple counties… more
- Planate Management Group LLC (Warren, MI)
- …with technical support centers in South East Asia and East Africa, that provide program management and facilities engineering services worldwide. Planate is a small ... business provider of planning, design, infrastructure management, technical consulting, engineering,...to deliver impactful recommendations to optimize facility use. The contract has been awarded to Planate and the period… more
- Trinity Health (Livonia, MI)
- …This system office position will oversee Linen Distribution and Laundry Contract management for Trinity Health (acute, seniors, and off-site clinics) **POSITION ... and peers at RHMs and within the region. Develops and implements effective cost reduction plans and implementation processes that support Trinity Health and RHM EVS… more
- Trinity Health (Livonia, MI)
- …as ICD-10, SNOMED CT and LOINC. + Provides subject matter expertise to managed care colleagues to improve contract language to reduce pre- and post-payment ... Clinical Services and the Revenue Excellence department to support quality of care and revenue objectives. This individual works closely with Regional Chief… more
- Trinity Health (Farmington Hills, MI)
- …assigned PBS needs and ensures continuous improvement in quality, operational cost effectiveness, customer satisfaction and resource utilization. Reviews billing and ... the area of responsibility; + Develops colleague work schedules to ensure cost effective staffing that meets customer requirements and financial performance; +… more