Pharmacy Operations Manager BrightSpring Health ServicesPharmacy Operations ManagerWarren, MIPharMerica, an affiliate of BrightSpring Health Services, delivers personalized pharmacy care through dedicated local teams, serving health care providers such as skilled nursing facilities, senior living communities, and hospitals. Partner with Client Services and Sales teams to maintain effective communication with facility staff (e.g., Directors of Nursing, Administrators, Registered Nurses) and resolve customer issues efficiently.
Administrative Manager Intermediate Troy Campus - Check In and Check Out University of MichiganAdministrative Manager Intermediate Troy Campus - Check In and Check OutTroy, MIThe Administrative Manager Intermediate of the Troy Center for Specialty Care, Advanced Imaging and Cardiovascular Center reports to the Administrative Director of the Troy Campus of Michigan Medicine, and partners with the Troy Campus Medical Directors and Nurse Supervisors for overall performance and management of the associated departments. Additionally, this role will provide leadership in guiding, implementing, and supporting service line and departmental operational initiatives and innovative, efficient care delivery models at Michigan Medicine, with a strong focus on expanding access, driving strategic growth, and optimizing the patient experience.
NewRN Case Manager Boost Home Healthcare - Southeast MichiganRN Case ManagerSouthfield, MIPart timeAs a member of our team, you’ll play a key role in providing quality home healthcare, where patients are able to remain independent at their place of residence in the healthiest and happiest state of being possible. Inspired by nurses, Boost Home Healthcare makes it easier for patients to focus on recovery and wellness by personalizing and coordinating care.
Strategic Account Manager - MidWest Travere Therapeutics IncStrategic Account Manager - MidWestMI$173,000–$225,000 / yearPosition Summary: Travere Therapeutics is seeking a dynamic, mission-driven Strategic Account Manager (SAM) to drive strategic alignment rooted in shared priorities with Integrated Delivery Networks (IDNs), Academic Centers of Excellence, and Large Nephrology Group Practices. By identifying mutual goals across clinical outcomes, operational efficiency, and population health impact, the SAM facilitates long-term partnerships that support clinical pathway integration, value-based care models, and multidisciplinary coordination.
Patient Advocate Rep III - Sinai Grace Conifer Health SolutionsPatient Advocate Rep III - Sinai GraceDetroit, MICross-coverage includes, but is not limited to, traveling to facility, screening patients for government program eligibility, completing necessary paperwork with patients, documenting decisions made on referrals in automated systems and in required departmental paperwork. Interacts with various levels of facility administration to communicate various departmental needs or issues and act as liaison when attending or leading facility meetings.
Account Manager/Specialty Account Manager - Ann Arbor, MI Amgen IncAccount Manager/Specialty Account Manager - Ann Arbor, MIDetroit, MI$145,311–$196,597 / yearIn addition to the base salary, Amgen offers a Total Rewards Plan comprising health and welfare plans for staff and eligible dependents, financial plans with opportunities to save towards retirement or other goals, work/life balance, and career development opportunities including: Comprehensive employee benefits package, including a Retirement and Savings Plan with generous company contributions, group medical, dental and vision coverage, life and disability insurance, and flexible spending accounts. In this vital role you will be representing Tavneos to physicians and healthcare professionals, playing a key role in establishing product demand and delivering comprehensive account management within a designated territory.
Specialty Account Manager, Endocrinology (Detroit) - Rare Disease AmgenSpecialty Account Manager, Endocrinology (Detroit) - Rare DiseaseDetroit, MichiganIn addition to the base salary, Amgen offers a Total Rewards Plan comprising health and welfare plans for staff and eligible dependents, financial plans with opportunities to save towards retirement or other goals, work/life balance, and career development opportunities including: Comprehensive employee benefits package, including a Retirement and Savings Plan with generous company contributions, group medical, dental and vision coverage, life and disability insurance, and flexible spending accounts. Must be able to work closely with patient services and market access team members, and understand their roles, to achieve overall business goals, Coordinate between accounts and relevant Amgen field teams to support full range of account needs, Educate healthcare professionals and office staff on site of care options.
RN Case Manager - Clinical Res Mgmt DMC Huron Valley-Sinai HospitalRN Case Manager - Clinical Res MgmtCharter Township of Commerce, MichiganThe individual’s responsibilities include the following activities: a) accurate LOS screening and submission for Physician Advisor review, b) care coordination, c) transition planning assessment and reassessment, d) implementation or oversight of implementation of the transition plan, e) leading and facilitating multi-disciplinary patient care conferences, f) managing concurrent disputes, g) making appropriate referrals to other departments, h ) identifying and referring complex patients to Social Work Services, i) communicating with patients and families about the plan of care, j) collaborating with physicians, office staff and ancillary departments, k) leading and facilitating Complex Case Review, l) assuring patient education is completed to support post-acute needs , m) timely complete and concise documentation in the Tenet Case Management documentation system, n ) maintenance of accurate patient demographic and insurance information, o) identification and documentation of potentially avoidable days, p) identification and reporting over and underutilization, q) and other duties as assigned. The RN Case Manager is responsible to facilitate care along a continuum through effective resource coordination to help patients achieve optimal health, access to care and appropriate utilization of resources, balanced with the patient’s resources and right to self-determination.
Utilization Management Case Manager University Health Services IncUtilization Management Case ManagerAUBURN HILLS, MIThese duties shall be directed toward supporting the hospital's mission in the pursuit of excellence in care/service and will include (but not limited to ): conducting timely admission and continues stay record reviews with external payers, utilizing approved criteria to make determinations of medical necessity and level of care planning, verifying active treatment by completing internal audit reviews within approved time frames, assisting the treatment team when indicated in the discharge planning process, and acting as liaison with MD/Clinical Treatment Team and external agencies. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located all over the U.S. States, Washington, D.C., Puerto Rico and the United Kingdom.
Key Account Manager - Great Lakes Myriad Genetics IncKey Account Manager - Great LakesDetroit, MI$235,796–$274,746 / yearBy leading initiatives that expand access, embed Myriad solutions into clinical workflows, and drive measurable clinical and business outcomes, you'll play a direct role in advancing the future of patient care. The KAM fuels growth by executing EMR and digital integrations, activating hereditary cancer screening protocols, and delivering high‑impact strategic initiatives across aligned clinical accounts and networks.
NewMgr, Digital Population Health Applications Transformation - IT - Full Time SolutionHealthMgr, Digital Population Health Applications Transformation - IT - Full TimeMIAbout the Job: The Manager, Digital Population Health Applications Transformation is responsible for leading the planning, delivery, and adoption of enhancements, optimization efforts, and transformational initiatives across the full compliment of Epic DPH Applications, including Epic Healthy Planet, MyChart, Cheers, Hello World, Welcome, EpicCare Link, and related digital population health capabilities. The Manager partners closely with Population Health, Clinical, Access, and operational leaders, as well as IT peers, to translate strategic priorities and business needs into executable roadmaps, funded initiatives, and measurable outcomes.
Clinical Manager RN Southeast MichiganClinical Manager RNSouthfield, Michigan$80,000–$110,000 / yearThe Clinical Manager supervises home health services to homebound patients in their place of residence in accordance with attending physician orders and plans of care and strives to provide the highest quality of care. As a member of our team, you’ll play a key role in providing quality home healthcare, where patients are able to remain independent at their place of residence in the healthiest and happiest state of being possible.
Regional Account Manager, IgAN Nephrology, Detroit, MI AstraZeneca PlcRegional Account Manager, IgAN Nephrology, Detroit, MIDearborn, MICreate and maintain strategically targeted account-specific business plans that reflect an in-depth understanding of local market forces impacting product sales, diagnostic pathways, referral patterns, and treatment adoption. Effectively utilize CRM tools to manage territory priorities, track account engagement, document sales activities, and submit required reports accurately and on time; and adopt CRM AI-embedded tools to prioritize opportunities and optimize call execution.
Registered Nurse - Case Manager - Pontiac Michigan CVS Health CorpRegistered Nurse - Case Manager - Pontiac MichiganPontiac, MI$60,522–$129,615 / yearManage transitions of care episodes for patients on their panel, including timely completion of structured clinical assessments to identify post-discharge needs, medication reconciliation on behalf of the PCP, and addressal of identified needs directly or via collaboration with other team members. Role Description: In partnership with the primary care provider, (PCP), the RN, Case Manager is the lead for care management activities, drives care coordination and collaborates with interdisciplinary teams to ensure care continuity for complex patients.
Life Sciences Experience Design Strategy Manager Deloitte Touche Tohmatsu LtdLife Sciences Experience Design Strategy ManagerDetroit, MI$163,400–$322,100 / yearWe are looking for practitioners who will work alongside Life Sciences organizations, from biotechnology firms to global big pharma to medical device companies, to drive business value through end-to-end delivery of experience design strategies that connect human insight to commercial impact. This role combines experience design strategy, digital product fluency, consulting execution, and Life Sciences commercial knowledge to help clients improve patient, provider, and business outcomes.
Territory Manager - Saint Clair Shores, MI Mineralys Therapeutics IncTerritory Manager - Saint Clair Shores, MISaint Clair Shores, MIRemote$130,000–$165,000 / yearMineralys Therapeutics is a clinical-stage biopharmaceutical company focused on developing medicines to target hypertension and related comorbidities such as chronic kidney disease (CKD), obstructive sleep apnea (OSA) and other diseases driven by dysregulated aldosterone. Collaborate closely with adjacent field partners including Field Reimbursement Managers, Territory Managers, and Regional Business Directors to support customer needs and territory objectives.
Territory Manager - Southfield, MI Mineralys Therapeutics IncTerritory Manager - Southfield, MISouthfield, MIRemote$130,000–$165,000 / yearMineralys Therapeutics is a clinical-stage biopharmaceutical company focused on developing medicines to target hypertension and related comorbidities such as chronic kidney disease (CKD), obstructive sleep apnea (OSA) and other diseases driven by dysregulated aldosterone. Collaborate closely with adjacent field partners including Field Reimbursement Managers, Territory Managers, and Regional Business Directors to support customer needs and territory objectives.
Territory Manager - Farmington, MI Mineralys Therapeutics IncTerritory Manager - Farmington, MIFarmington, MIRemote$130,000–$165,000 / yearMineralys Therapeutics is a clinical-stage biopharmaceutical company focused on developing medicines to target hypertension and related comorbidities such as chronic kidney disease (CKD), obstructive sleep apnea (OSA) and other diseases driven by dysregulated aldosterone. Collaborate closely with adjacent field partners including Field Reimbursement Managers, Territory Managers, and Regional Business Directors to support customer needs and territory objectives.
Territory Manager - Dearborn, MI Mineralys Therapeutics IncTerritory Manager - Dearborn, MIDearborn, MIRemote$130,000–$165,000 / yearMineralys Therapeutics is a clinical-stage biopharmaceutical company focused on developing medicines to target hypertension and related comorbidities such as chronic kidney disease (CKD), obstructive sleep apnea (OSA) and other diseases driven by dysregulated aldosterone. Collaborate closely with adjacent field partners including Field Reimbursement Managers, Territory Managers, and Regional Business Directors to support customer needs and territory objectives.
Territory Manager - Troy, MI Mineralys Therapeutics IncTerritory Manager - Troy, MITroy, MIRemote$130,000–$165,000 / yearMineralys Therapeutics is a clinical-stage biopharmaceutical company focused on developing medicines to target hypertension and related comorbidities such as chronic kidney disease (CKD), obstructive sleep apnea (OSA) and other diseases driven by dysregulated aldosterone. Collaborate closely with adjacent field partners including Field Reimbursement Managers, Territory Managers, and Regional Business Directors to support customer needs and territory objectives.
Registered Nurse (RN) - Case Manager DMC Receiving HospitalRegistered Nurse (RN) - Case ManagerDetroit, MIThe individuals responsibilities include the following activities: a) accurate medical necessity screening and submission for Physician Advisor review, b) care coordination, c) transition planning assessment and reassessment, d) implementation or oversight of implementation of the transition plan, e) leading and facilitating multi-disciplinary patient care conferences, f) managing concurrent disputes, g) making appropriate referrals to other departments, h ) identifying and referring complex patients to Social Work Services, i) communicating with patients and families about the plan of care, j) collaborating with physicians, office staff and ancillary departments, k) leading and facilitating Complex Case Review, l) assuring patient education is completed to support post-acute needs, m) timely complete and concise documentation in Case Management system, n ) maintenance of accurate patient demographic and insurance information, o) identification and documentation of potentially avoidable days, p) identification and reporting over and underutilization, q) and other duties as assigned. The RN Case Manager is responsible to facilitate care along a continuum through effective resource coordination to help patients achieve optimal health, access to care and appropriate utilization of resources, balanced with the patients resources and right to self-determination.
Clinic Manager Farmington Hills, MI Athletico LtdClinic Manager Farmington Hills, MIFarmington Hills, MIAthletico clinicians are supported by Generative AI Documentation Scribe - purpose-built AI technology that automatically generates compliant clinical documentation in real time, so you can stay fully present with your patients and deliver the meaningful, undivided care they deserve. This may include onboarding new employees, training current employees, reviewing treatment plans and being an important part of the community you serve - ultimately enhancing our patient's health and quality of life.
Account Manager/Specialty Account Manager - TEPEZZA - Grand Rapids, MI Amgen IncAccount Manager/Specialty Account Manager - TEPEZZA - Grand Rapids, MIDetroit, MI$173,255–$203,081 / yearIn addition to the base salary, Amgen offers a Total Rewards Plan comprising health and welfare plans for staff and eligible dependents, financial plans with opportunities to save towards retirement or other goals, work/life balance, and career development opportunities including: Comprehensive employee benefits package, including a Retirement and Savings Plan with generous company contributions, group medical, dental and vision coverage, life and disability insurance, and flexible spending accounts. Must be able to work closely with patient services and market access team members, and understand their roles, to achieve overall business goals, Coordinate between accounts and relevant Horizon field teams to support full range of account needs, Educate healthcare professionals and office staff on site of care options.
Manager - Transplant Service Revenue Mgmt. (Detroit, MI) Henry Ford HospitalManager - Transplant Service Revenue Mgmt. (Detroit, MI)Detroit, MIGENERAL SUMMARY: As a member of the Transplant Institute and hospital revenue cycle team, manages, coordinates or participates in a wide variety of operational and personnel functions related to Insurance Verification, Medicaid Application Services, Registration Services, EC2000 and other related "front-end" and billing processes. Coordinates with key revenue cycle departments including ATMO, DEM, Clinic and OR to assure successful business processes fit and perform within required clinical needs resulting in appropriate reimbursement for the Hospital and System.
Social Worker MSW Care Manager Corewell HealthSocial Worker MSW Care ManagerSouthfield, MIDemonstrates expertise, current knowledge in care and management of a caseload of members of varying complexity and seeks to improve member, family, and health systems / community outcomes through the application of educational concepts / skills and preventive care in a managed care environment. Collaborate with providers, community organizations, and systems to coordinate care and ensure members and their families are connected to the resources needed to promote health and wellbeing, and advocate and address any barriers to access needed services.
Social Worker MSW Care Manager Priority Health Corewell HealthSocial Worker MSW Care Manager Priority HealthSouthfield, MichiganDemonstrates expertise, current knowledge in care and management of a caseload of members of varying complexity and seeks to improve member, family, and health systems / community outcomes through the application of educational concepts / skills and preventive care in a managed care environment. Collaborate with providers, community organizations, and systems to coordinate care and ensure members and their families are connected to the resources needed to promote health and wellbeing, and advocate and address any barriers to access needed services.
Care Manager - Hematology Oncology Oakland Trinity Health CorporationCare Manager - Hematology Oncology OaklandPontiac, MIMINIMUM EXPERIENCE: 3-5 years of clinical experience with oncology patients in primary care/ambulatory care, home health agency, skilled nursing facility, or hospital, within the past five years: knowledge of chronic conditions, evidence-based guidelines, prevention, wellness, health risk assessment, and patient education. In this role, you'll help patients navigate their healthcare journey through clinical triage, care coordination, patient education, and ongoing support that improves outcomes and enhances the patient experience.
Clinical Adoption Manager - Detroit, MI Hologic IncClinical Adoption Manager - Detroit, MIDetroit, MI$120,000–$150,000 / yearDrive adoption, utilization, and growth of Hologic's RFA portfolio by helping physicians identify more patients, build successful fibroid treatment programs, and deliver exceptional patient outcomes through consistent clinical and commercial partnership. Working in partnership with the Account Executive, the RFA Clinical Adoption Manager serves as a clinical and commercial resource to physicians, office staff, and health system stakeholders to drive patient identification, referral development, physician confidence, and procedural volume growth.
Workers Comp Case Manager Munson HealthcareWorkers Comp Case ManagerMIIf you want a career in healthcare and a lifestyle most people only dream about - with freshwater lakes, scenic trails, charming downtowns, a vibrant arts scene, and endless outdoor adventures - you might just be Munson Material. Responsible for coordinating work-related injury cases from report through return to work, collaborating with Occupational Health providers, managers, employees, and third party administrators.
Area Business Manager - Detroit PharvarisArea Business Manager - DetroitDetroit, MIFull timeBy targeting this clinically proven therapeutic target with novel, oral small molecules, the Pharvaris team is advancing new alternatives to injected therapies for the prevention and treatment of hereditary angioedema (HAE) attacks, and other bradykinin B2-receptor-mediated indications. This is a highly visible field-based role requiring strong clinical selling capability, strategic thinking, cross-functional collaboration, and a passion for improving outcomes for patients living with rare disease.
District Manager, Women''''s Health - Midwest Viatris IncDistrict Manager, Women''''s Health - MidwestMIRemote$148,000–$222,000 / yearEvery day, we rise to the challenge to make a difference and here's how the District Manager, Womens Health - Midwest role will make an impact: Key responsibilities for this role include: The Midwest district includes key markets in Pennsylvania, Ohio, Michigan, Indiana, and Illinois. We do so via: • Access - Providing high quality trusted medicines regardless of geography or circumstance; • Leadership - Advancing sustainable operations and innovative solutions to improve patient health; • Partnership - Leveraging our collective expertise to connect people to products and services.
RN Manager - ECT Program Acadia Healthcare Co IncRN Manager - ECT ProgramWest Bloomfield, MICollaborate with interdisciplinary treatment teams, other departments and administration to ensure that all residents' physical, biopsychosocial, age, developmental and cultural needs are met and when they are not met, acknowledges and works to resolve customer complaints. PURPOSE STATEMENT: Assists the DON/CNO with directing, planning, coordinating, monitoring and supervising the effective and efficient use of the operations of nursing for assigned units.
C2C LMSW/LPC Case Manager (Full Time) MyCare Health CenterC2C LMSW/LPC Case Manager (Full Time)Center Line, MIThe TCM works as part of a multi-disciplinary care team to ensure patients gain access to appropriate medical, behavioral health, substance use disorder (SUD), educational, and social services. 5 FTE for this position will be focused on providing therapeutic services to adult patients diagnosed with Behavioral Health Disorders and Substance Use Disorders (as well as other co-occurring disorders).
Long Term Care (LTC) Sales Account Manager Detroit, MI Shionogi & Co LtdLong Term Care (LTC) Sales Account Manager Detroit, MIDetroit, MI$125,000–$175,000 / yearEffectively and consistently call on LTC facilities and affiliated business entities daily through one-on-one meetings and presentations, professional education programs and other appropriate means, targeting HCPs (MDs/NPs), Medical Directors, Administrators, DONs, consultant pharmacists, and pharmacy directors to educate on clinical profile, access process, and appropriate utilization. The Long-Term Care (LTC) Sales Account Manager is responsible for establishing access and generating demand in targeted LTC settings, including but not limited to Skilled Nursing Facilities, Nursing Homes, and LTC Pharmacies within an assigned territory.
Field Reimbursement Manager Immunology Rheumatology - Detroit MI AbbVie IncField Reimbursement Manager Immunology Rheumatology - Detroit MIDetroit, MIApplicable only to applicants applying to a position in any location with pay disclosure requirements under state or local law: The compensation range described below is the range of possible base pay compensation that the Company believes in good faith it will pay for this role at the time of this posting based on the job grade for this position. The amount and availability of any bonus, commission, incentive, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Companys sole and absolute discretion unless and until paid and may be modified at the Company's sole and absolute discretion, consistent with applicable law.
Patient Service Representative Dental Care AlliancePatient Service RepresentativeCanton, MichiganFull timeThey will answer phones, handle patient inquiries, make appointments, and assist with the completion of the patient’s treatment plans through acceptable financial arrangements while being flexible in handling requests and projects assigned by other staff and/or the Office Manager. Overview: Contemporary Dentistry is looking for a Patient Service Representative in Canton, Michigan , to join our clinical team by providing a high level of patient care and satisfaction while operating team-based environment.
Manager, Revenue Cycle Analytics - Full Time Days - Hybrid Henry Ford HospitalManager, Revenue Cycle Analytics - Full Time Days - HybridTroy, MIGENERAL SUMMARY: The Manager of Revenue Cycle Analytics is responsible for leading the Revenue Cycle Analytics team in designing, developing and implementing robust and sustainable analytical solutions to drive revenue cycle results across the health system. The manager is expected to understand complex revenue cycle, clinical, and operational practices and acts with a high degree of autonomy in managing analytics projects, routine reporting, and overall team capacity.
Case Manager Trinity Health CorporationCase ManagerLivonia, MITrinity Health Livonia is a beautiful full-service, 304-bed acute care hospital, located in Livonia, MI, that provides comprehensive care, including a 24-hour emergency department, general medicine, inpatient and outpatient surgery, physical medicine and rehabilitation, intensive care unit, cancer, cardiology, geriatrics and birthing and women's health. The Case Manager will assess patient needs, facilitates inpatient planning using criteria sets, collaborating with physicians and other healthcare providers to develop a safe and appropriate plan of care for patients.
Mgr Pharmacy Corewell HealthMgr PharmacyRoyal Oak, MIAs Corewell Health's system-wide provider of home infusion services, we deliver specialized therapies including total parenteral nutrition (TPN), anti-infectives, biologics, inotropes, and pain management therapies. This leader will drive operational excellence, advance clinical practice, and partner with physicians, nurses, and executive leaders to expand access, improve patient outcomes, and support sustainable growth.
Pharmacy Manager Home Infusion Corewell HealthPharmacy Manager Home InfusionRoyal Oak, MichiganAs Corewell Health's system-wide provider of home infusion services, we deliver specialized therapies including total parenteral nutrition (TPN), anti-infectives, biologics, inotropes, and pain management therapies. This leader will drive operational excellence, advance clinical practice, and partner with physicians, nurses, and executive leaders to expand access, improve patient outcomes, and support sustainable growth.
Manager, Assessment & Referral University Health Services IncManager, Assessment & ReferralAUBURN HILLS, MIOperating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located all over the U.S. States, Washington, D.C., Puerto Rico and the United Kingdom. Work experience in a hospital setting preferred Current License in the State of Michigan as a Fully Licensed Social Worker (LMSW), Licensed Marriage & Family Therapist (LMFT), Licensed Professional Counselor (LPC) or Registered Nurse (RN) required.
Practice Manager Trinity Health CorporationPractice ManagerRochester Hills, MIIn conjunction with the Associate Division Director, Division Director and SMD, meets regularly with practice providers to review material from Operating Team meetings, financials including provider productivity and budget status report, and to review progress on goals and CORE work plan. Works closely with the SMD, practice supervisors, Associate Division Director and the Division Director to ensure that IHA employees are of the appropriate number and mix of competencies, skill levels, educational and experiential backgrounds, and other qualifications.
Clinic Manager - Farmington Hills, MI Athletico Physical TherapyClinic Manager - Farmington Hills, MIFarmington Hills, MichiganFull timeAthletico clinicians are supported by Generative AI Documentation Scribe - purpose-built AI technology that automatically generates compliant clinical documentation in real time, so you can stay fully present with your patients and deliver the meaningful, undivided care they deserve. This may include onboarding new employees, training current employees, reviewing treatment plans and being an important part of the community you serve – ultimately enhancing our patient’s health and quality of life.
Strategic Account & Growth Manager BrightSpring Health ServicesStrategic Account & Growth ManagerDetroit, MIRemotePharMerica, an affiliate of BrightSpring Health Services, delivers personalized pharmacy care through dedicated local teams, serving health care providers such as skilled nursing facilities, senior living communities, and hospitals. The Strategic Account & Growth Manager is responsible for driving market growth in long term care while maintaining, expanding and strengthening relationships with prescribers and pharmaceutical partners with Blake Pharmacy across an assigned region.
Sr. Manager, Pricing - Pharmacy Appeals CVS Health CorpSr. Manager, Pricing - Pharmacy AppealsMI$67,900–$182,549 / yearThis role requires a thorough knowledge of claim adjudication, appeals related processes, and being a leader working with other internal business units to develop new solutions to meet the ever-increasing number of complex appeal bill compliance requirements. Leads with strategic leadership and guidance to pharmacy reimbursement appeals teams, ensuring effective strategies and operations are effectively progressed to improve performance.
Registered Nurse Case Manager (RN) - Case Management Tenet Healthcare CorpRegistered Nurse Case Manager (RN) - Case ManagementDetroit, MIThe individuals responsibilities include the following activities: a) accurate medical necessity screening and submission for Physician Advisor review, b) care coordination, c) transition planning assessment and reassessment, d) implementation or oversight of implementation of the transition plan, e) leading and facilitating multi-disciplinary patient care conferences, f) managing concurrent disputes, g) making appropriate referrals to other departments, h ) identifying and referring complex patients to Social Work Services, i) communicating with patients and families about the plan of care, j) collaborating with physicians, office staff and ancillary departments, k) leading and facilitating Complex Case Review, l) assuring patient education is completed to support post-acute needs, m) timely complete and concise documentation in Case Management system, n ) maintenance of accurate patient demographic and insurance information, o) identification and documentation of potentially avoidable days, p) identification and reporting over and underutilization, q) and other duties as assigned. The RN Case Manager is responsible to facilitate care along a continuum through effective resource coordination to help patients achieve optimal health, access to care and appropriate utilization of resources, balanced with the patients resources and right to self-determination.
Registered Nurse (RN) - Case Manager Tenet Healthcare CorpRegistered Nurse (RN) - Case ManagerDetroit, MIThe individuals responsibilities include the following activities: a) accurate medical necessity screening and submission for Physician Advisor review, b) care coordination, c) transition planning assessment and reassessment, d) implementation or oversight of implementation of the transition plan, e) leading and facilitating multi-disciplinary patient care conferences, f) managing concurrent disputes, g) making appropriate referrals to other departments, h ) identifying and referring complex patients to Social Work Services, i) communicating with patients and families about the plan of care, j) collaborating with physicians, office staff and ancillary departments, k) leading and facilitating Complex Case Review, l) assuring patient education is completed to support post-acute needs, m) timely complete and concise documentation in Case Management system, n ) maintenance of accurate patient demographic and insurance information, o) identification and documentation of potentially avoidable days, p) identification and reporting over and underutilization, q) and other duties as assigned. Job Description: The RN Case Manager is responsible to facilitate care along a continuum through effective resource coordination to help patients achieve optimal health, access to care and appropriate utilization of resources, balanced with the patients resources and right to self-determination.
Health - Network Performance / Utilization Manager Accenture PlcHealth - Network Performance / Utilization ManagerDetroit, MIStrategy & Consulting: We work with C-suite executives, leaders and boards of the world's leading organizations, helping them reinvent every part of their enterprise to drive greater growth, enhance competitiveness, implement operational improvements, reduce cost, deliver sustainable 360° stakeholder value, and set a new performance frontier for themselves and the industry in which they operate. Accenture is a leading global professional services company that helps the world's leading businesses, governments and other organizations build their digital core, optimize their operations, accelerate revenue growth and enhance citizen services-creating tangible value at speed and scale.
PACS Technical Support Management Manager - Full Time - Remote Experity IncPACS Technical Support Management Manager - Full Time - RemoteMIRemote$90,900–$110,000 / yearCommunicate and collaborate effectively with other functional leaders by solving business challenges together, identifying growth opportunities, and collaborating to drive efficiency and effectiveness across the organization, while focusing on support. Experity is a mission-driven team transforming on-demand healthcare across the U.S., empowering urgent care clinics with industry-leading software that makes care faster, easier, and more patient-focused.