4 clinical review auditor jobs found in Detroit

The Graphic Design Specialist is an integral part of the Emergent Holdings communications team and will manage projects from ideation and design to production with adherence to the Emergent Holdings brand standards and the ability to drive a consistent visual identity. Based in the Detroit or Grand Rapids areas, this person will lead design projects for the division, including brand development, corporate identity, corporate presentations, infographics, print and digital advertising, website design, and trade show graphics – all aligned to support strategic, measurable goals. Working knowledge of SharePoint sites, websites, HTML and WordPress required. The Graphic Design Specialist must have strong multimedia design skills, be highly motivated, organized and detail-oriented with the ability to perform multiple tasks simultaneously and adapt to changing priorities. This person must also be able to collaborate and thrive in a small team, work under tight timelines with changing...

Department Summary:  The position partners closely with cybersecurity teams, business units, privacy, legal, compliance, audit, and technology organizations to identify, assess, monitor, and reduce data-related risks across cloud, SaaS, endpoint, collaboration, and on-premises environments while enabling business objectives and regulatory compliance. The position also will be critical to review and update our Security posture from a Data Security and Data Loss Prevention as we expand our AI build and capabilities.  Position Summary The Information Security Specialist II – Data Security (DSPM & Data Loss Prevention) serves as a senior subject matter expert responsible for the design, implementation, governance, and continuous improvement of the enterprise Data Security Program. This role provides strategic and technical leadership for Data Security Posture Management (DSPM), Data Loss Prevention (DLP), Data Classification, Information and Data Protection, Insider...

Responsible for the completion of assignments for the coordination of the Quality Management Program through problem identification, development and coordination of QM studies, investigation of quality-related member and practitioner inquiries, and plan compliance with state and federal regulations and accrediting bodies.  Measures and analyzes results of QI activities, recommends interventions, and conducts follow-up. Collaborates with Care Management, Customer Services, Provider Affairs, and other departments to provide rapid and thorough identification, investigation and resolution of member, practitioner, and provider quality related issues. Works with plan Medical Director on development and revision of Clinical Practice Guidelines.  Assists management with the revision of Quality Management policies. Develops, maintains, and enhances reporting methods to identify trends in physician and member behavior.  Completes applicable...

Job Type: Full time   Exempt/Non Exempt:   Hourly Job Description:   Location: Dearborn, Michigan Position Schedule / Shift: Hybrid schedule Monday – Friday: 8:00 AM EST – 5:00 PM EST. Employees will report once per week to the Dearborn Administrative Office Building and work remaining days from their home office. Position Summary: Join a fast-paced Claims team where your work directly impacts the customer experience during some of their most important moments. In this role, you'll leverage your problem-solving skills and attention to detail to support claim operations, coordinate Total Loss processes, and connect with customers to provide timely solutions and guidance. Working across multiple systems and business areas, you'll play a key role in keeping claims moving efficiently while building valuable industry knowledge and experience in a collaborative environment. Key Responsibilities: Provide support to the Claim department by...