Director, Healthcare Services - REMOTE Molina Healthcare IncDirector, Healthcare Services - REMOTEWarren, MIRemoteRegistered Nurse (RN), Licensed Vocational Nurse (LVN), Licensed Practical Nurse (LPN), Licensed Clinical Social Worker (LCSW), Licensed Marriage and Family Therapist (LMFT), Licensed Professional Clinical Counselor (LPCC), or Licensed Master of Social Work (LMSW). At least 8 years of health care experience, and at least 5 years of managed care experienced in one or more of the following areas: utilization management, care management, care transitions, behavioral health, long-term services and supports (LTSS), or equivalent combination of relevant education and experience.
Remote Healthcare Customer Service Representative EveriseRemote Healthcare Customer Service RepresentativeMIRemoteFull timep>While working from your home, as aHealthcare Customer Service Representative, you’ll be the Over-The-Counter Retail members' first point of contact. Join our team and be part of a mission-driven program that makes a real impact for Federal Employee Program members every day.
Independent Healthcare Recruiter (Remote) SYDIERA Healthcare StaffingIndependent Healthcare Recruiter (Remote)Detroit, MichiganRemoteAs an Independent Healthcare Recruiter, you’ll help connect qualified healthcare professionals with opportunities at healthcare organizations across a variety of care settings. SYDIERA Healthcare Staffing is seeking motivated, relationship-focused individuals to join our growing recruiter network.
Auditor, Healthcare Services (Remote in MI) Molina Healthcare IncAuditor, Healthcare Services (Remote in MI)Detroit, MIRemotePerforms audits in utilization management, care management, member assessment, behavioral health, and/or other clinical teams, and monitors clinical staff for compliance with National Committee for Quality Assurance, Centers for Medicare and Medicaid Services (CMS), and state/federal guidelines and requirements. At least 2 years health care experience, with at least 1 year experience in utilization management, care management, and/or managed care, or equivalent combination of relevant education and experience.
Aurora Response and Support Call Center (Healthcare/Mental Health) - Remote Aurora Community ServicesAurora Response and Support Call Center (Healthcare/Mental Health) - RemoteMIRemoteWe are seeking passionate and committed individuals to work in our call center; providing a one-stop resource for individuals needing a wide range of services, providing telephonic assistance with the Employee Achievement Program (EAP), Crisis Line, Scheduling/On Call, Injury Hotline, and Mental Health Support. For 40 years, Aurora has been a leader in providing customized services that support individuals with disabilities, chronic mental illness, and traumatic brain injuries in residential settings.
Remote Registered Nurse (Remote Patient Monitoring & Chronic Care Management) 3:15Remote Registered Nurse (Remote Patient Monitoring & Chronic Care Management)Detroit, MIRemote$55,000–$65,000Assist patients in the navigation of their healthcare (example - assisting patients with scheduling appointments, coordinating with specialists, and ensuring preventative screenings are completed, etc.). We are looking for a qualified Registered Nurse (RN) to serve our patient population in the navigation, prevention and management of their health through continuous care programs like Remote Patient Monitoring and Chronic Care Management.
Care Coordinator Registered Nurse - Remote in Michigan McLaren Health Care CorpCare Coordinator Registered Nurse - Remote in MichiganFlint, MIRemotePosition Summary: As an advocate for the patient, the RN care manager will assess, plan, implement, coordinate, monitor, and evaluate the options and services required to meet an individual's health needs, using clinical and community resources to promote quality, cost effective outcomes. Completes timely post-hospital follow up: Medication reconciliation, PCP or specialist follow-up appointment, assess symptoms, teach warning signs, review discharge instructions, coordination of care, and problem solve barriers.
Commercial & Healthcare Regulatory Counsel Alto IncCommercial & Healthcare Regulatory CounselMIRemote$135,000–$185,000 / yearPhysical requirements for this role include the ability to work at a computer terminal with monitor, keyboard and mouse for extended periods of time, stoop, bend, and reach for equipment and supplies, make frequent repetitive motions required to operate a computer that include the wrists, hands and fingers, and lift, carry, push, pull, and move light objects up to 20 pounds. Issue-spot and provide practical guidance on applicable laws and regulations, such as the Anti-Kickback Statute (AKS), Stark Law, False Claims Act, FDA/DEA requirements relevant to pharmacy and telehealth operations, state pharmacy/professional licensing, PBM contracting/network participation, and HIPAA/HITECH.
Healthcare Claims Quality Analyst Integra PartnersHealthcare Claims Quality AnalystTroy, MIRemoteFull timeThe Claims Quality Assurance Analyst is responsible for monitoring and documenting production quality in support of departmental goals and initiatives, with a primary focus on claims auditing and claims-related interactions within the Revenue Cycle Management (RCM) function. Working knowledge of Revenue Cycle Management (RCM) workflows and downstream impacts (e.g., clean claim submission, edits, denials, appeals, payment posting/reconciliation) across commercial, Medicaid, and Medicare.
NewHealthcare Project Manager Stefanini, IncHealthcare Project ManagerGrand Rapids, MIRemoteAbout Stefanini Group: The Stefanini Group is a global provider of offshore, onshore and near shore outsourcing, IT digital consulting, systems integration, application, and strategic staffing services to Fortune 1000 enterprises around the world. Our presence is in countries like the Americas, Europe, Africa, and Asia, and more than four hundred clients across a broad spectrum of markets, including financial services, manufacturing, telecommunications, chemical services, technology, public sector, and utilities.
Remote Nurse Practitioner Contractor- Multi-State Perry Health IncRemote Nurse Practitioner Contractor- Multi-StateMichigan Center, MIRemoteWe provide expert diabetes education and clinical management for Medicare patients, delivered by a comprehensive team of specialized Registered Nurses, Registered Dietitians, and Accountability Coaches. Skills: Motivated learner, willing to acquire proficiency with the necessary technology (computers, software applications, phone systems); experience or training in Motivational Interviewing to support sustainable behavior change is a plus.
Remote Community Based Clinical Coordinator - Care Manager - Chippewa County, MI Upper Peninsula Health PlanRemote Community Based Clinical Coordinator - Care Manager - Chippewa County, MIMIRemoteWorks as a member advocate and collaborates with support teams, medical care offices, medical equipment companies, home health agencies, hospital care teams, and other parties to ensure appropriate discharge plan, care plan, and coordination of acute care and long-term care services. Preferred: Bachelor of science in nursing, limited licensed bachelor of social work, limited licensed master of social work, fully licensed bachelor of social work, or fully licensed master of social work.
Remote Community Based Clinical Coordinator - Care Manager - Mackinac County, MI Upper Peninsula Health PlanRemote Community Based Clinical Coordinator - Care Manager - Mackinac County, MISt. Ignace, MIRemoteWorks as a member advocate and collaborates with support teams, medical care offices, medical equipment companies, home health agencies, hospital care teams, and other parties to ensure appropriate discharge plan, care plan, and coordination of acute care and long-term care services. Preferred: Bachelor of science in nursing, limited licensed bachelor of social work, limited licensed master of social work, fully licensed bachelor of social work, or fully licensed master of social work.
Remote Community Based Clinical Coordinator - Care Manager - Emmet County, MI Upper Peninsula Health PlanRemote Community Based Clinical Coordinator - Care Manager - Emmet County, MIPetoskey, MIRemoteWorks as a member advocate and collaborates with support teams, medical care offices, medical equipment companies, home health agencies, hospital care teams, and other parties to ensure appropriate discharge plan, care plan, and coordination of acute care and long-term care services. Preferred: Bachelor of science in nursing, limited licensed bachelor of social work, limited licensed master of social work, fully licensed bachelor of social work, or fully licensed master of social work.
Remote Community Based Clinical Coordinator - Care Manager - Cheboygan County, MI Upper Peninsula Health PlanRemote Community Based Clinical Coordinator - Care Manager - Cheboygan County, MIcheboygan, MIRemoteWorks as a member advocate and collaborates with support teams, medical care offices, medical equipment companies, home health agencies, hospital care teams, and other parties to ensure appropriate discharge plan, care plan, and coordination of acute care and long-term care services. Preferred: Bachelor of science in nursing, limited licensed bachelor of social work, limited licensed master of social work, fully licensed bachelor of social work, or fully licensed master of social work.
Remote Community Based Clinical Coordinator - Care Manager - Otsego County, MI Upper Peninsula Health PlanRemote Community Based Clinical Coordinator - Care Manager - Otsego County, MIMIRemoteWorks as a member advocate and collaborates with support teams, medical care offices, medical equipment companies, home health agencies, hospital care teams, and other parties to ensure appropriate discharge plan, care plan, and coordination of acute care and long-term care services. Preferred: Bachelor of science in nursing, limited licensed bachelor of social work, limited licensed master of social work, fully licensed bachelor of social work, or fully licensed master of social work.
Remote Community Based Clinical Coordinator - Care Manager - Charlevoix, County Upper Peninsula Health PlanRemote Community Based Clinical Coordinator - Care Manager - Charlevoix, CountyBoyne City, MIRemoteWorks as a member advocate and collaborates with support teams, medical care offices, medical equipment companies, home health agencies, hospital care teams, and other parties to ensure appropriate discharge plan, care plan, and coordination of acute care and long-term care services. Preferred: Bachelor of science in nursing, limited licensed bachelor of social work, limited licensed master of social work, fully licensed bachelor of social work, or fully licensed master of social work.
NewRemote Community Based Clinical Coordinator - Care Manager - Ontonagon County, MI Upper Peninsula Health PlanRemote Community Based Clinical Coordinator - Care Manager - Ontonagon County, MIontonagon, MIRemoteWorks as a member advocate and collaborates with support teams, medical care offices, medical equipment companies, home health agencies, hospital care teams, and other parties to ensure appropriate discharge plan, care plan, and coordination of acute care and long-term care services. Preferred: Bachelor of science in nursing, limited licensed bachelor of social work, limited licensed master of social work, fully licensed bachelor of social work, or fully licensed master of social work.
NewRemote Community Based Clinical Coordinator - Care Manager - Dickinson County, MI Upper Peninsula Health PlanRemote Community Based Clinical Coordinator - Care Manager - Dickinson County, MIIron Mountain, MIRemoteWorks as a member advocate and collaborates with support teams, medical care offices, medical equipment companies, home health agencies, hospital care teams, and other parties to ensure appropriate discharge plan, care plan, and coordination of acute care and long-term care services. Preferred: Bachelor of science in nursing, limited licensed bachelor of social work, limited licensed master of social work, fully licensed bachelor of social work, or fully licensed master of social work.
NewRemote Community Based Clinical Coordinator - Care Manager - Gogebic County, MI Upper Peninsula Health PlanRemote Community Based Clinical Coordinator - Care Manager - Gogebic County, MIIronwood, MIRemoteWorks as a member advocate and collaborates with support teams, medical care offices, medical equipment companies, home health agencies, hospital care teams, and other parties to ensure appropriate discharge plan, care plan, and coordination of acute care and long-term care services. Preferred: Bachelor of science in nursing, limited licensed bachelor of social work, limited licensed master of social work, fully licensed bachelor of social work, or fully licensed master of social work.