regulatory Jobs in Detroit, MI

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Provider Contracts Manager

Molina Healthcare

•

Detroit, Michigan, USA

Full-time

Remote and must live in Michigan JOB DESCRIPTION Job Summary Negotiates agreements with highly visible providers including integrated delivery systems, hospitals and physician groups that result in high quality, cost effective and marketable providers. KNOWLEDGE/SKILLS/ABILITIES In conjunction with Director/Manager Provider Contracts, negotiates high priority physician group and facility contracts using Preferred, Acceptable, Discouraged, Unacceptable (PADU) guidelines. Develops and maintains pr
Posted 7 hours ago

Senior Specialist, Provider Network Administration

Molina Healthcare

•

Warren, Michigan, USA

Full-time

JOB DESCRIPTION Job Summary Provider Network Administration is responsible for the accurate and timely validation and maintenance of critical provider information on all claims and provider databases. Staff ensure adherence to business and system requirements of internal customers as it pertains to other provider network management areas, such as provider contracts. KNOWLEDGE/SKILLS/ABILITIES Generates and prepares provider-related data and reports in support of Network Management and Operations
Posted 7 hours ago

Provider Contracts Manager

Molina Healthcare

•

Warren, Michigan, USA

Full-time

Remote and must live in Michigan JOB DESCRIPTION Job Summary Negotiates agreements with highly visible providers including integrated delivery systems, hospitals and physician groups that result in high quality, cost effective and marketable providers. KNOWLEDGE/SKILLS/ABILITIES In conjunction with Director/Manager Provider Contracts, negotiates high priority physician group and facility contracts using Preferred, Acceptable, Discouraged, Unacceptable (PADU) guidelines. Develops and maintains pr
Posted 7 hours ago

IT Compliance & Security Analyst

Stefanini

•

Dearborn, Michigan, USA

Contract

Stefanini Group is hiring! Stefanini is looking for an IT Compliance & Security Analyst, Dearborn, MI (Hybrid) For quick apply, please reach out Parul Singh at / IT Compliance and Security Analyst provides oversight of IT Security and controls, supports the IT compliance and regulatory requirements. You will play a key role in our Second Line of Defense, supporting our IT Compliance and Regulatory requirements. This position is responsible for providing support for internal and external audits,
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Posted 31 days ago | Updated 2 hours ago

IT Audit Team Leader

Comerica

•

Auburn Hills, Michigan, USA

Full-time

IT Audit Team Leader The IT Audit Team Leader manages and serves as a senior subject matter expert (SME) in the execution of complex IT audits of IT systems, cybersecurity, and data management processes. This role is responsible for planning, supervising, and executing audit engagements to ensure high-quality deliverables which align with regulatory requirements, and timely reporting of results. The IT Audit Team Leader provides independent, objective recommendations to senior management while
Posted 1 day ago | Updated 6 hours ago

Business Analyst

Strategic Staffing Solutions

•

Detroit, Michigan, USA

Contract

STRATEGIC STAFFING SOLUTIONS (S3) HAS AN OPENING! Strategic Staffing Solutions is currently looking for a Business Analyst (CMS Regulations / Risk) for a contract opportunity with one of our largest clients located in Detroit, MI! Title: Business Analyst Location: Detroit, MI 48226 (Remote with 1 day onsite/ week) Duration: 5 Months Role Type: W2 Contract Engagement Engagement Description: This engagement requires a highly skilled Risk Adjustment Business Analyst who can bridge regulatory requir
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Posted 11 days ago | Updated moments ago

Senior Specialist, Provider Network Administration

Molina Healthcare

•

Sterling Heights, Michigan, USA

Full-time

JOB DESCRIPTION Job Summary Provider Network Administration is responsible for the accurate and timely validation and maintenance of critical provider information on all claims and provider databases. Staff ensure adherence to business and system requirements of internal customers as it pertains to other provider network management areas, such as provider contracts. KNOWLEDGE/SKILLS/ABILITIES Generates and prepares provider-related data and reports in support of Network Management and Operations
Posted 7 hours ago

Provider Contracts Manager

Molina Healthcare

•

Sterling Heights, Michigan, USA

Full-time

Remote and must live in Michigan JOB DESCRIPTION Job Summary Negotiates agreements with highly visible providers including integrated delivery systems, hospitals and physician groups that result in high quality, cost effective and marketable providers. KNOWLEDGE/SKILLS/ABILITIES In conjunction with Director/Manager Provider Contracts, negotiates high priority physician group and facility contracts using Preferred, Acceptable, Discouraged, Unacceptable (PADU) guidelines. Develops and maintains pr
Posted 7 hours ago

GRC Lead

Kforce Technology Staffing

•

Detroit, Michigan, USA

Full-time

RESPONSIBILITIES: Kforce has a client in Detroit, MI that is seeking a GRC Lead. Responsibilities: * The GRC Lead is responsible for establishing, implementing, and maintaining a corporate-wide information security governance program designed to help ensure the Security program and it's supporting capabilities and processes are effectively protecting information and system assets * Responsible for proactively identifying, evaluating and reporting on information security risks in a manner that m
Posted 38 days ago | Updated 1 hour ago

HR Recruitment Operations Specialist

Stefanini

•

Southfield, Michigan, USA

Contract

Stefanini Group is hiring! Stefanini is looking for an HR Recruitment Operations Specialist in Southfield, MI 48033 (Hybrid) For quick Apply, please reach out to Avneesh Katiyar, call / email: Job Title: HR Recruitment Operations Specialist Location: 26701 Telegraph Rd, Southfield, MI 48033 (Hybrid) (This role will be hybrid and hours are flexible. Typically have coverage anywhere from 7-4 up to 3 days a week with main days being Monday-Thursday. Heavy days are definitely Monday/Tuesday/Wednesda
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Posted 17 days ago | Updated 2 hours ago

IT Audit Consultant

Crox Consulting Inc

•

Detroit, Michigan, USA

Contract

Responsibilities: Support control risk management, IT controls, and related regulatory and compliance standards Perform internal audit assurance activities (financial, operational, compliance, IT, SOX, SOC reporting, etc.), propose suggestions for process automation and other technology-oriented solutions Review documentation for control testing activities, including for general IT controls, automated controls, reports, and interfaces Facilitate use of technology-based tools or methodologies to
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Posted 60+ days ago | Updated 1 day ago

Capital Project Manager

Strategic Staffing Solutions

•

Detroit, Michigan, USA

Contract

STRATEGIC STAFFING SOLUTIONS (S3) HAS AN OPENING! Strategic Staffing Solutions is currently looking for a Capital Project Manager for a contract opportunity with one of our largest clients located in Detroit, MI! Title: Capital Project Manager Location: Detroit, MI (Hybrid/onsite 3 days per week) Duration: 24+ Months W2 Engagement Description: Responsible for the design and construction and/or commissioning of intermediate to large-size capital renewable projects. May be asked to train and mento
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Posted 21 days ago | Updated moments ago

Senior Analyst, Risk & Quality Reporting (Remote)

Molina Healthcare

•

Remote or Detroit, Michigan, USA

Full-time

Job Description Job Summary The Sr Analyst, Risk and Quality Reporting role supports Molina's Risk and Quality Health Plan team. Designs and develops custom health plan reports to support local interventions, provider outreach, and tracks outcomes of the initiatives. Educates users on how to use reports related to Risk and Quality/HEDIS for Medicaid, Marketplace and Medicare/MMP. Assists with research, development, and completion of special performance improvement projects including root cause
Posted 7 hours ago

Sr. Project Manager (Commerical Lending Migrations Project exp required)

OpTech

•

Farmington Hills, Michigan, USA

Contract

Why work at OpTech? OpTech is a woman-owned company that values your ideas, encourages your growth, and always has your back. When you work at OpTech, not only do you get health and dental benefits on the first day of employment, but you also have training opportunities, flexible/remote work options, growth opportunities, 401K and competitive pay. Apply today! Role: Sr. Project Manager (Commercial Lending Migrations) Location: Multiple locations to choose from Auburn Hills, MI, Farmington MI o
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Posted 19 days ago

Construction Project Engineer

Jobot

•

Detroit, Michigan, USA

Full-time

Join a leading construction firm where your skills and ambition will thrive in an environment that values innovation, teamwork, and excellence. This Jobot Job is hosted by: Don Seawall Are you a fit? Easy Apply now by clicking the "Apply Now" button and sending us your resume. Salary: $70,000 - $90,000 per year A bit about us: Our client is a nationally recognized construction firm with a rich history of delivering high-quality projects in commercial, healthcare, industrial, and multifamily s
Posted 1 day ago | Updated 2 hours ago

Business Analyst Cloud Modernization (Banking & Payments)

Swanktek

•

Troy, Michigan, USA

Contract

Position: Business Analyst Cloud Modernization (Banking & Payments) Location: Troy, Michigan(Hybrid) Project: Payment Hub need candidates from Banking domain only. Type of hire: Contract W2 Job Description: Required Skills & Experience Experience: 5+ years as a Business Analyst in banking, payments, or financial services, with at least 2 years on cloud migration or modernization projects.Hands-on experience with payment systems (e.g., ISO 20022, SWIFT, SEPA, FPS, RTGS) and real-time/instant paym
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Posted 11 days ago

Cyber Security Analyst

The Talent Advantage Group

•

Farmington Hills, Michigan, USA

Full-time

1889 - Cybersecurity Analyst- Cybersecurity AnalystPosition OverviewWe are seeking a seasoned Senior Cybersecurity Analyst to proactively protect enterprise systems and data. The ideal candidate will lead advanced threat detection, analysis, and incident response efforts while working across a broad IT and cloud infrastructure. This opportunity is with a large manufacturing and distribution company operating across multiple sites and states, utilizing a variety of ERP systems to manage operation
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Posted 6 days ago | Updated 5 days ago

Senior Analyst, Risk & Quality Reporting (Remote)

Molina Healthcare

•

Remote or Warren, Michigan, USA

Full-time

Job Description Job Summary The Sr Analyst, Risk and Quality Reporting role supports Molina's Risk and Quality Health Plan team. Designs and develops custom health plan reports to support local interventions, provider outreach, and tracks outcomes of the initiatives. Educates users on how to use reports related to Risk and Quality/HEDIS for Medicaid, Marketplace and Medicare/MMP. Assists with research, development, and completion of special performance improvement projects including root cause
Posted 7 hours ago

Principal Data Scientist - Generative AI, Machine Learning, Python, R - Remote

Molina Healthcare

•

Remote or Detroit, Michigan, USA

Full-time

Job Description Job Summary Responsible for overseeing data science projects, managing and mentoring a team, and aligning data initiatives with business goals. Lead the development and implementation of data models, collaborate with cross-functional teams, and stay updated on industry trends. Ensure ethical data use and communicate complex technical concepts to non-technical stakeholders. Lead initiatives on model governance and model ops to align with regulatory and security requirements. This
Posted 6 hours ago

Senior Specialist, Provider Network Administration

Molina Healthcare

•

Rochester, Michigan, USA

Full-time

JOB DESCRIPTION Job Summary Provider Network Administration is responsible for the accurate and timely validation and maintenance of critical provider information on all claims and provider databases. Staff ensure adherence to business and system requirements of internal customers as it pertains to other provider network management areas, such as provider contracts. KNOWLEDGE/SKILLS/ABILITIES Generates and prepares provider-related data and reports in support of Network Management and Operations
Posted 7 hours ago