Priority Health Jobs in United States

About Priority Health · Priority Health is Michigan's second-largest and fastest-growing health plan, dedicated to improving health and lives across the state. · Negotiate health system and physician contracts. · Lead a team of contracting professionals by providing guidance and ...

Develops multi-media training solutions with a primary focus on Epic and other Health Systems. Partners with training team members, subject matter experts, and customers to develop audience-specific training. · ...

While maintaining the integrity of the sensitive information of our membership,a Pharmacy Customer Service Representative is to provide efficient and accurate responses to external customers (physicians/office staff, pharmacy providers,members,and agents) and internal team member ...

This role leads and supports initiatives and tasks associated with the management of Priority Health Commercial products and vendor relationships. · ...

Coordinates educational plans for Behavioral Health Care Management departments in conjunction with Medical Management leadership. · ...

This role will design develop implement and deliver curriculum to meet the current and future needs of Customer Service. This includes instructor led as well as e-learning. · Develops implements and evaluates educational / training strategies. · Researches assesses analyzes emplo ...

Job Summary:Provide efficient and accurate responses to external customers (physicians/office staff, pharmacy providers,members,and agents) regarding health plan benefits. · ...

You will be performing home visits in either Barry, Berrien, Branch, Calhoun, Cass, Kalamazoo, · St. Joseph or Van Buren counties. Flexible schedules are available. · ...

Provides efficient and accurate responses to external customers and internal team members regarding health plan benefits. Educates customers on drug formulary guidelines. · ...

A Provider Operations Associate Analyst is responsible for identifying and solving issues relating to the performance of provider operations business. · ...

The coding analyst will assist in developing solutions to prevent overpayments identified by vendors. They will apply root cause analysis findings to develop prevention solutions and support their implementation within Priority Health. · Coordinate with vendors to review findings ...

Provide efficient and accurate responses to external customers regarding health plan benefits including accessing services, resolving complex problems, pharmacy claim rejections and overrides, group/member eligibility problems, and other non-routine questions. · ...

Certified nursing assistants provide essential care and support services to patients in hospice settings. · ...

The Lead Change Management Specialist in Priority Health's Transformation Office will guide our organization through strategic changes, · ensuring the adoption of new processes, technologies and business strategies are achieved with minimal disruption.This role is critical in fos ...

Provides job instruction training to Access Management employees in the areas of pre-encounter and point of service encounter. · Bachelor's Degree or equivalent related field · CRT-Registered Health Information Technician (RHIT) · ...

This is a hybrid position combining utilization management and education experience. · As Medical Management Educator within Utilization Management,The role includes being an Epic Credentialed Trainer from March - October 2026, · returning to the Utilization Management team upon ...

Provides complex services to support senior vice president level executives in strategic management of the organization. · ...

Overview · The Director, Product Manager is responsible for managing outcomes for products in the value stream, including market success of product(s); solving problems for customers while achieving business goals; analyzing market and customer data, and working closely with othe ...

We are committed to cultivating and investing in YOU. · Provides direct patient care under the direction of the Unit Manager or Licensed Nurse. · ...

The position will support non-contracted provider post claim appeals submitted to the health plan. · Associate's Degree or equivalent · 5 years of relevant experience Grievance & or Appeal Analyst or related experience ...