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 ...

Job Summary · The Manager, Risk Mitigation is the thought leader role responsible for the design, implementation, and execution of auditing programs ensuring the accuracy, compliance, and integrity of risk adjustment processes. This role mitigates financial, operational and compl ...

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

Provides job instruction training to Access Management employees in the areas of pre-encounter and point of service encounter; utilizing multiple patient management systems to enhance performance and minimize failure. · ...

The Grievance Coordinator is responsible for analyzing and researching complex member appeal investigationsEffectively administer all steps of the member appeal and fair hearing processes for all non-Medicare products. · ...

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 ...

This is a remote position. The role requires that you have an active Pharmacy Technician license. · Lead, coach, and elevate a high‑impact pharmacy team. · Step into a leadership role where pharmacy expertise, people development, and Medicare quality outcomes come together. The M ...

About Priority Health · Priority Health is Michigan's second-largest and fastest-growing health plan, dedicated to improving health and lives across the state. Our success as a nationally recognized nonprofit health benefits company is driven by the incredible talent and commitme ...

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 ...

The Manager Medicare Stars Quality Improvement manages the Quality and Senior Quality Improvement Specialists. · Supports quality improvement activities with annual project plans outlining measurable deliverables. · Expertise in leading team activities in a manner that is organiz ...

The Risk Adjustment (RA) Senior Encounter Data Systems Analyst plays a key role within the Risk Adjustment (RA) Encounters team, managing and enhancing the full lifecycle of the Encounter Data Submission process across all applicable lines of business. · This position requires de ...

The Senior Training and Development Specialist will be responsible for developing and implementing organizational-wide learning curriculum. · ...

Manages the Quality and Senior Quality Improvement Specialists and their work. · ...

The Risk Adjustment Senior Encounter Data Systems Analyst plays a key role within the Risk Adjustment Encounters team managing and enhancing the full lifecycle of the Encounter Data Submission process across all applicable lines of business. · This position requires deep knowledg ...

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

· This individual will support the marketing team in executing on projects driving new business growth, retention and distribution channel marketing and communications. · ...

Supports the technology and operational construction of new products; ongoing maintenance of and operational support for existing products, and investigation and resolution of product performance issues. · Supports the successful delivery of identified product solutions through t ...

This position will support our non-contracted provider post claim appeals submitted to the health plan. · Responsible for complex member appeal investigations including: formulate action plan to ensure all activities are completed by the regulatory time line,evaluate information ...

Supports the technology and operational construction of new products; ongoing maintenance of and operational support for existing products, and investigation and resolution of product performance issues. · ...

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) · ...