61 jobs found in Detroit

Shift – 8:30am-5:00pm M-F; shift bidding process based on seniority. Site/Location: Detroit, MI Status – Regular Full Time       Provide thorough analysis and investigation of authorization requests for specialized medical/surgical/outpatient procedures in an expeditious and accurate manner ensuring provider, hospital/facility, Primary Care Group (PCG), and member quality customer service. Provide information and assistance pertaining to the Medical Management program to providers, hospitals, PCGs and members. Assess and investigate requests for medical service authorization and authorize select services that do not require clinical judgment. Collect and record appropriate data to issue authorization and route request for services that require medical review to appropriate team member(s).  Facilitate communication with providers regarding status on authorizations and referrals. Identify relevant issues and route to appropriate department for action and resolution....

Analytics Governance Team Summary: The Analytics Governance team, within the Analytics Center of Excellence, is responsible for establishing and overseeing enterprise standards for analytics methodologies, derived measures, tools, and Responsible AI practices.  The team manages analytics asset inventory, leads governance forums and risk management activities, and enables consistent, compliant, and well documented analytic practices across the enterprise. The Analytics Governance team, within the Analytics Center of Excellence, is responsible for establishing and overseeing enterprise standards for analytics methodologies, derived measures, tools, and Responsible AI practices.  The team manages analytics asset inventory, leads governance forums and risk management activities, and enables consistent, compliant, and well documented analytic practices across the enterprise. Departmental Responsibilities: Support Responsible AI governance activities, including...

WHAT WE'RE LOOKING FOR Berkshire Hathaway Homestate Companies, Workers Compensation Division, is looking for a Business Development Manager in Michigan!  This individual will be responsible for business development efforts and brand strategy within a specified territory.  This involves evaluation of production patterns in new and renewal business to uncover opportunities for refinements to support profitable growth.  You will work collaboratively with other Business Development Managers, Underwriting management, and additional corporate resources to develop opportunities by industry, class code or segment, and to more effectively monitor/evaluate agency performance. You'll stay ahead of competitive intelligence and help prevent production barriers, as well as develop opportunities to improve ease of doing business with BHHC and provide input to improve overall customer experience.  Frequent travel within a specified territory required.   Must be legally authorized to...

Description Summary: Exciting opportunity to become a Commercial Relationship Manager III and member of the Middle Market Banking group in Detroit, MI. The candidate will act as a trusted advisor and primary point of contact for existing and prospective commercial banking clients with revenues between $50 million to $1 billion plus. The candidate will have a genuine opportunity to gain valuable experience, develop skills, and position themselves for upward career mobility. Duties & Responsibilities: Disciplined and motivated self-starter who can manage business development efforts with minimal management oversight. Develops and deepens relationships with clients and prospective clients through consultative selling and introductions to appropriate bank partners in treasury management, capital markets, insurance, wealth and private banking, and retail banking. Lead team of cross-functional colleagues in...

Non-Exempt/Bargaining Unit Posting Date Posted: 03/18/2026 Date Closed: 03/25/2026 Local/Seniority Unit – 1781/3207 Department – 126460 Grp Cust Membership & Billing Salary Grade – A Number of openings – Multiple Shift – Mon-Fri Flex start between 7a-8:30a Site/Location: Jefferson Building Status – Regular Full Time   This is a training level position aimed at acquiring the necessary skills and knowledge required to review enrollment and supporting documentation and decide to approve or deny the application based on applicable policy. Establishes, updates and maintains both subscriber and group records via direct input and/or manual transactions.  Sends standard correspondences. Successful completion of the first 90 days (quality/attendance/production etc.) will result in advancement to the Account Clerk II position. Review documentation to determine eligibility and review and approve, reject, or pend enrollment...

Perform a broad range of administrative duties for Senior Vice President.   Performs advanced, diversified and confidential secretarial and administrative duties while working within general established guidelines, using judgment and discretion. Prepares correspondence, memoranda, reports, etc. Initiates routine and some non-routine correspondence and memoranda. Screens telephone calls and visitors and resolves routine and complex inquiries. Schedules appointments, meetings and travel itineraries, and coordinates related arrangements. May prepare and distribute minutes of meetings.   EDUCATION AND EXPERIENCE   High School Graduate or GED equivalent required. Three (3) years of secretarial experience required.   " Qualifications " Typing speed of 45 w.p.m. required.  Proficient in the use of PC applications, i.e., Excel and Word. Excellent organizational skills, strong verbal and written communication skills required....

Responsible for managing infrastructure that supports the Third-Party Administrators (TPA) product solution that allows BCBSM to bring competitive product offerings to market and support the product moving forward. Serve as a liaison between the group, operations, group account leaders and Information Technology to ensure roles, responsibilities, and performance expectations are clearly defined and followed by all for effective operations. Define and lead a process to support and manage FlexLink relationships that exist with TPAs as well as customer groups who support this solution. Work with operations to clarify roles, responsibilities and expectations; Support new programs, initiatives or regulations. Manage, create and enhance reporting for Flex Link related performance to ensure timely claim processing.  Partner with operations to establish an appropriate cadence and produce a performance tracking...

Responsible to identify, prioritize and develop strategies to support Blue Cross Blue Shield of Michigan’s (BCBSM) competitive position, achieve positive business results, and improve the health and wellbeing of our members.  Responsible to make recommendations on consequential matters with long-term implications for the organization, including: setting enterprise aspirations and targets, developing enterprise-level strategies, assessing strategic investments and partnerships, and evaluating the enterprise’s overall portfolio of assets. Oversee or perform analyses including, but not limited to, financial modeling, claims analyses and complex statistical analyses.   Manage activities that are directly related to the corporate strategies, goals and objectives.     Utilize primary and secondary research to assist in identifying best practices and opportunities for the corporation.   Create executive level PowerPoint presentations and correspondence to...

Why GMF Technology? Innovation isn’t just a talking point at GM Financial, it’s how we operate. From generative AI and cloud-native technologies to peer-led learning and hackathons, our tech teams are building real solutions that make a difference. We’re committed to AI-powered transformation, using advanced machine learning and automation to help us reimagine customer interactions and modernize operations, positioning GM Financial as a leader in digital innovation within a dynamic industry. Join us and discover a workplace where your ideas matter, your development is prioritized, and you can truly make a global impact. Flexible hybrid work environment (onsite 2 days a week/3 days remote) at our Detroit, MI or Arlington (AOC1), TX office. Please note: We are unable to provide any type of sponsorship for this position currently.  About The Role: The Senior Microsoft 365 Business System Analyst is a senior technical specialist responsible for architecting,...

SUMMARY:  This position is responsible for the Medication Adherence program for BCBSM senior members. The Director will design and execute a multi-year strategy that improves adherence rates and achieves Star measure performance goals. The Director will report to the Managing Director of Pharmacy Quality and oversee a large, multidisciplinary team of pharmacists, pharmacy technicians, data analysts, and external vendors. This role requires strong cross‑functional collaboration with clinical, operations, IT, finance, and external partners to integrate adherence initiatives, drive performance, and apply emerging digital tools and analytics to scale impact. The ideal candidate combines deep pharmacy expertise with proven leadership, strategic thinking, change-management skills and the ability to influence stakeholders at all levels. RESPONSIBILITIES/TASKS: • Serves as the department lead and subject-matter expert for CMS Star Medication Adherence measure performance; interpret...

Employment-based non-immigrant visa sponsorship and/or assistance is not offered for this specific job opportunity. We will only consider candidates who are currently authorized to work in the United States and who will not require sponsorship now or in the future. Please note student visas, CPT, OPT, H-1B, TN, and other temporary work authorizations are considered restricted forms of employment eligibility. Once these expire, the candidate must be able to present another valid form of work authorization.   Detroit: Fully remote/hybrid Create a career that goes in the direction you choose. Get to know opportunity. The Business Join one of the fastest growing areas of our retirement business!  The Actuarial Delivery Group (ADG) is a growing group of colleagues within the North American Retirement Line of Business who focus on operational excellence and systems expertise. As integrated members of client teams in a variety of offices, they provide high quality and...

Responsible for assisting and supporting management in the evaluation, recommendation, establishment, implementation and analysis of new and improved production workflows, work processes for systems, reporting and new products/programs to improve customer service levels and overall quality. Support the development, coordination, and implementation of clinical criteria products to enhance the overall efficiency of operational procedures within PA hub, methods, controls, and performance. Compile and analyze operational data to identify and resolve business problems. Utilize and maintain available reporting systems. Participate in systems testing, develop procedures/controls and provide recommendations for the ongoing improvement of the updated process. Provide leadership team with status updates on projects and issues. Communicate and recommend policy changes to achieve project objectives. Assist in documenting departmental procedures. Create and present reports and...

Functions as a highly skilled internal control consultant responsible for conducting audits/reviews of business processes, business units, vendors, suppliers or Par Plans, and/or providing risk education and consulting services on behalf of the corporation to mitigate risk and assess the control environment of each audit unit. Provides guidance and training for audit team. Conduct internal audits and reviews to identify risks, document established controls to mitigate risk and assess the control environment of each auditable unit. Communicate issues, audit results, and recommendations in a clear and concise manner to appropriate levels of operating and executive management, including activity updates to the Audit Committee of the Board of Directors.  Assist in the development of the annual audit plan through risk universe identification. Facilitate project risk assessments and lessons learned sessions. Conduct management...

Why GM Protection Sales?   GM Protection focuses on branded vehicle protection product sales as part of GM Financial, the wholly owned subsidiary and captive finance arm of General Motors.  Our sales team spans the United States working with GM dealers on a variety of initiatives to drive product sales, customer loyalty, and profitability for the dealers and the brand.  As a trusted advisor, you will consult with various roles within GM dealerships and collaborate with internal partners to represent GM Financial and GM Protection. If you are able to build relationships, have a heart and mind for service, communicate effectively, and enjoy a fast-paced variety in a challenging field-based role, this could be the right place for you.      If you would like to be a part of a company with an entrepreneurial spirit, join GM Protection’s sales organization to develop your network and career with a stable, growing, global brand.  About the role:  You...

It’s a great time to join AAA The Auto Club Group!   JOIN THE TEAM COMMITTED TO DRIVING YOUR CAREER FORWARD Job Type: Full time   Exempt/Non Exempt:   Salary Job Description:   This is a hybrid position reporting to our Detroit office 2 days a week. Associate Attorney – AAA/The Auto Club Group Reports to: Supervising Practice Leader Under moderate supervision, handle litigation and cases of intermediate-level exposure and complexity in which the insured or the Company is a defendant.  Able to transition from courts of limited exposure to courts of unlimited exposure.  Develops and applies skills to control all aspects of litigation, including trial preparation, discovery, negotiation, presentation and appeals from District to Circuit Court.  Primary Duties and Responsibilities (details of the basic job functions): Reviews and analyzes files, insurance policies, all allegations and pertinent medical and technical...

The Sr Financial Analyst is responsible for monitoring, analyzing and reporting financial information including revenue and expenses by account, customer and product segments.  These duties may include variance analysis, account reconciliation, transaction processing and publishing of various financial reports and financial statements. Prepares financial information and reviews for accuracy and completeness.  Performs detailed analysis when necessary. Other deliverables may include account reconciliations, impact studies, audit findings, budgets and business cases.  Assists with the preparation of various financial or regulatory reports and/or statements for management and/or parties external to BCBSM (e.g., auditors, customers, providers, CMS, BCBSA, FEP, OFIS, etc). Prepares financial reporting for a division, customer or segment that may include linking financial information from various sources to provide meaningful financial reports or to assure appropriate...

Why Quantitative Pricing at GM Financial?  The Sr Quantitative Analyst - Pricing plays a key role in enhancing pricing strategies and processes through pricing model development and data driven business solutions. The Associate will focus on improving model integrity and accuracy through the collection, analysis, interpretation, and presentation of origination and forecast data. They will also apply advanced quantitative and analytical skills to improve decisions supporting various internal clients. This position will interact with many other departments to achieve overall company objectives. About the role  Develop and maintain complex pricing models and perform profitability analysis for all of International Operations  Monitoring and validating model performance and updating models as needed  Developing and maintaining various databases, technical models, and reports required to support product and pricing proposals and analytic responsibilities...

Responsible for serving as a technology risk advisor conducting internal information technology (IT) audits and reviews, providing risk education and project risk assessment on behalf of the corporation to mitigate risk and assess the control environment of each auditable unit.  Develops and communicates risks and recommended controls for multiple layers of leadership.  Provides guidance for lower level Corporate and IT audit staff. Assess risks across cybersecurity, cloud technologies, enterprise platforms, data governance, and digital transformation initiatives. Provide advisory support to technology and business teams on emerging risks, control design, and risk mitigation strategies during new initiatives and projects. Conduct internal audits and reviews to identify risks, document established controls to mitigate risk and assess the control environment of each auditable unit. Communicate issues, audit results, and recommendations in a clear and concise manner to...

Conduct compliance investigations and lead the execution of moderately complex initiatives for Blue Cross Blue Shield of Michigan (BCBSM) and its subsidiaries. Analyze and develop documentation to support regulatory changes and departmental policies and procedures. Conduct comprehensive and moderately complex regulatory analyses to include the review, summarization and dissemination of compliance reports. Provide support and recommendations for privacy investigations to mitigate business risk. Develop work flows to define the documentation of department processes, report generation, and process improvements. Define assigned project scope and deliverables to support compliance initiatives. Partner with the business to drive compliance as a core competency and integrate compliance into business plans, scorecards, metrics and processes. Promote compliance awareness by supporting training, programs and departmental activities. Provide support or lead government audit...

Description Summary: Our branch banking roles offer a welcoming and inclusive team environment where you are empowered every day to help our customers achieve their financial goals.  Our branch colleagues have an opportunity to share ideas and voice opinions that directly impact our customers, our bank, and our communities for the better.  As a Branch Manager, you are responsible for management of the branch; leading all facets of sales, service and operations of the branch; coaching on existing processes, leading the team in achieving budgeted production goals, acquiring new consumer and business customers; initiating referrals to partners, and deepening all existing customer relationships proactively driving business inside and outside of the branch; and responsible for consistent business development and calling program. Duties & Responsibilities: Managing portfolio of high value consumer and...