3 Healthcare Administrators jobs in Troy
Project Manager - Healthcare Claims Management
Posted today
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Job Description
Job Description
The Project Manager – Healthcare Claims Management (Subject Matter Expert) is responsible for leading complex projects and initiatives related to claims adjudication, processing, compliance, and operational improvements. This role requires deep subject matter expertise in healthcare claims systems, workflows, and regulatory requirements. The PM will collaborate with cross-functional teams to ensure timely, accurate, and compliant claims operations while driving strategic enhancements.
SALARY: $95,000.00/Annually
JOB QUALIFICATIONS: KNOWLEDGE/SKILLS/ABILITIES
The PM’s responsibilities include but are not limited to:
- Lead and manage end-to-end projects focused on healthcare DME claims.
- Serve as the subject matter expert for claims workflows, system configurations, and industry best practices.
- Oversee requirements gathering, business analysis, and documentation of claims processes.
- Ensure claims-related projects meet compliance with HIPAA, CMS, Medicaid, and other applicable regulations.
- Partner with IT, operations, and vendor teams to resolve system defects, improve processing accuracy, and optimize turnaround times.
- Manage stakeholder communications, project status reporting, and escalation of risks or issues.
- Facilitate user acceptance testing (UAT) for claims-related enhancements and system changes.
- Monitor and track project performance, ensuring deliverables are met within scope, budget, and schedule.
EXPERIENCE:
- 5+ years of experience in healthcare claims management, with at least 3 years in a project management capacity.
- Deep knowledge of claims adjudication systems (e.g., QNXT, Facets, HealthEdge) and HIPAA EDI transactions (837, 835, 277, 820).
- Proven experience leading cross-functional projects in a payer or managed care environment.
- Strong understanding of CMS, Medicaid, and state-specific claims regulations.
- Excellent communication, organizational, and analytical skills.
Benefits Offered
- Competitive compensation and annual bonus program
- 401(k) retirement program with company match
- Company-paid life insurance
- Company-paid short term disability coverage (location restrictions may apply)
- Medical, Vision, and Dental benefits
- Paid Time Off (PTO)
- Paid Parental Leave
- Sick Time
- Paid company holidays and floating holidays
- Quarterly company-sponsored events
- Health and wellness programs
- Career development opportunities
Remote Opportunities
We are actively seeking new colleagues in: Arizona, Colorado, Connecticut, Florida, Georgia, Idaho, Illinois, Kentucky, Massachusetts, Michigan, North Carolina, New Jersey, New York, Ohio, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, Vermont, and Washington.
Our Story
Founded in 2005, Integra Partners is a leading national durable medical equipment, prosthetic, and orthotic supplies (DMEPOS) network administrator. Our mission is to improve the quality of life for the communities we serve by reimagining access to in-home healthcare. We connect Payers, Providers, and Members through innovative technology and streamlined workflows affording Members access to top local Providers and culturally competent care. By focusing on transparency, accountability, and adaptability, we help deliver better health outcomes and more efficient management of complex healthcare benefits. Integra Partners is a wholly owned subsidiary of Point32Health.
With a location in Michigan plus a remote workforce across the United States, Integra has a culture focused on collaboration, teamwork, and our values: One Team, Drive Results, Push the Boundaries, Value Others, and Build Community. We’re looking for energetic, talented, and dedicated individuals to join our team. See what opportunities we have available; there may be a role for you to engage in a challenging yet rewarding career in healthcare. We look forward to learning more about you.
Integra Partners is an equal opportunity employer. We are committed to providing reasonable accommodations and will work with you to meet your needs. If you are a person with a disability and require assistance during the application process, please don’t hesitate to reach out. We celebrate our inclusive work environment and welcome members of all backgrounds and perspectives.
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Medical Education Administrator - Department of Ophthalmology Visual & Anatomical Sciences
Posted today
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Job Description
Medical Education Administrator - Department of Ophthalmology Visual & Anatomical Sciences
Wayne State University is searching for an experiencedMedical Education Administrator - Department of Ophthalmology Visual & Anatomical Sciencesat its Detroit campus location.
Wayne State is a premier, public, urban research university located in the heart of Detroit, Michigan where students from all backgrounds are offered a rich, high-quality education. Our deep-rooted commitment to excellence, collaboration, integrity, diversity and inclusion creates exceptional educational opportunities which prepare students for success in a global society.
Essential functions (job duties):
Job Purpose:
The Medical Education Administrator plays a key role in supporting the Department of Ophthalmology’s educational mission at Wayne State University School of Medicine (WSU SOM). This position provides administrative coordination across multiple levels of medical education, including support for medical students interested in ophthalmology, ophthalmology fellowship programs (Retina, Glaucoma and Oculoplastics), continuing medical education (CME) activities, and the residency program. This position reports to the Residency Program Manager. The Administrator works closely with the Residency Program Manager and the Director of Medical Student Education to ensure efficient and compliant execution of all educational activities and departmental initiatives.
Essential Functions:
Medical Student Education:
Collaborate with the Director of Medical Student Education to support the Ophthalmology clerkship and sub-internship rotations.
Coordinate schedules, evaluations and orientation materials for the WSU School of Medicine students rotating through the department.
Assist with student engagement and communication, including interest group activities and events
Fellowship Program Support:
Retina Fellowship Coordinator
Provide administrative assistance to Glaucoma and OPRS fellowship programs.
Support creation and distribution of call schedules, coordination of educational conferences and fellow onboarding/credentialing.
Track certification and training requirements, ensuring compliance with institutional and program-specific standards.
Residency Program Support:
Provide day-to-day administrative support to the Residency Program Manager and Education Coordinator.
Assist with documentation, scheduling, credentialing, and compliance activities related to residency training.
Help Prepare for Accreditation Council for Graduate Medical Education accreditation and internal reviews.
Continuing Medical Education (CME):
Manage CME activity documentation, including attendance tracking, faculty disclosures and activity recertification.
Work with designated faculty members to ensure timely submission of CME applications and renewals.
Maintain accurate CME records in compliance with accreditation standards
General Educational Initiatives:
Assist in the coordination of departmental education events, including lectures, grand rounds, and special academic programs.
Maintain databases and rosters related to learners, faculty educators and educational activities.
Provide logistical and administrative support for departmental meetings, evaluations, and reports.
Perform other related duties as assigned.
Unique duties:
Qualifications:
Education: Bachelor's degree
Bachelor’s degree in education, healthcare administration, or related program/major from an accredited college or university preferred. Work-related experience in lieu of a Bachelor’s degree will be considered.
Experience: Entry level (less that a year of job-related experience)
1-2 years’ experience in graduate medical education or academic administration preferred.
Experience with regulatory processes including Accreditation Council for Graduate Medical Education (ACGME), Liaison Committee on Medical Education (LCME) or Continuing Medical Education (CME).
Knowledge, Skills, and Abilities:
Excellent organizational, communication, and multitasking skills.
Proficiency in Microsoft Office Suite and web-based scheduling or learning platforms.
Familiarity with academic medical environments and electronic evaluation or credentialing systems.
Preferred qualifications:
School/College/Division:
H06 - School of Medicine
Primary department:
H0621 - Ophthalmology, Visual and Anatomical Sciences
Employment type:
-
Regular Employee
-
Job type: Full Time
-
Job category: Staff/Administrative
Funding/salary information:
-
Compensation type: Annual Salary
-
Hourly rate:
-
Salary minimum: TBD
-
Salary hire maximum: TBD
Working conditions:
This position is 40 hours per week and requires an in-office presence at Kresge Eye Institute. Some early morning or evening hours may be required during peak academic or event planning periods. Normal office environment.
Job openings:
-
Number of openings: 1
-
Reposted position: No
-
Reposted reason: None (New Requisition)
-
Prior posting/requisition number:
Background check requirements:
University policy requires certain persons who are offered employment to undergo a background check, including a criminal history check, before starting work. If you are offered employment, the university will inform you if a background check is required.
Medical Education Administrator - Department of Ophthalmology Visual & Anatomical Sciences
Posted today
Job Viewed
Job Description
Wayne State University is searching for an experiencedMedical Education Administrator - Department of Ophthalmology Visual & Anatomical Sciencesat its Detroit campus location.
Wayne State is a premier, public, urban research university located in the heart of Detroit, Michigan where students from all backgrounds are offered a rich, high-quality education. Our deep-rooted commitment to excellence, collaboration, integrity, diversity and inclusion creates exceptional educational opportunities which prepare students for success in a global society.
Essential functions (job duties):
Job Purpose:
The Medical Education Administrator plays a key role in supporting the Department of Ophthalmology's educational mission at Wayne State University School of Medicine (WSU SOM). This position provides administrative coordination across multiple levels of medical education, including support for medical students interested in ophthalmology, ophthalmology fellowship programs (Retina, Glaucoma and Oculoplastics), continuing medical education (CME) activities, and the residency program. This position reports to the Residency Program Manager. The Administrator works closely with the Residency Program Manager and the Director of Medical Student Education to ensure efficient and compliant execution of all educational activities and departmental initiatives.
Essential Functions:
Medical Student Education:
Collaborate with the Director of Medical Student Education to support the Ophthalmology clerkship and sub-internship rotations.
Coordinate schedules, evaluations and orientation materials for the WSU School of Medicine students rotating through the department.
Assist with student engagement and communication, including interest group activities and events
Fellowship Program Support:
Retina Fellowship Coordinator
Provide administrative assistance to Glaucoma and OPRS fellowship programs.
Support creation and distribution of call schedules, coordination of educational conferences and fellow onboarding/credentialing.
Track certification and training requirements, ensuring compliance with institutional and program-specific standards.
Residency Program Support:
Provide day-to-day administrative support to the Residency Program Manager and Education Coordinator.
Assist with documentation, scheduling, credentialing, and compliance activities related to residency training.
Help Prepare for Accreditation Council for Graduate Medical Education accreditation and internal reviews.
Continuing Medical Education (CME):
Manage CME activity documentation, including attendance tracking, faculty disclosures and activity recertification.
Work with designated faculty members to ensure timely submission of CME applications and renewals.
Maintain accurate CME records in compliance with accreditation standards
General Educational Initiatives:
Assist in the coordination of departmental education events, including lectures, grand rounds, and special academic programs.
Maintain databases and rosters related to learners, faculty educators and educational activities.
Provide logistical and administrative support for departmental meetings, evaluations, and reports.
Perform other related duties as assigned.
Unique duties:
Qualifications:
Education: Bachelor's degree
Bachelor's degree in education, healthcare administration, or related program/major from an accredited college or university preferred. Work-related experience in lieu of a Bachelor's degree will be considered.
Experience: Entry level (less that a year of job-related experience)
1-2 years' experience in graduate medical education or academic administration preferred.
Experience with regulatory processes including Accreditation Council for Graduate Medical Education (ACGME), Liaison Committee on Medical Education (LCME) or Continuing Medical Education (CME).
Knowledge, Skills, and Abilities:
Excellent organizational, communication, and multitasking skills.
Proficiency in Microsoft Office Suite and web-based scheduling or learning platforms.
Familiarity with academic medical environments and electronic evaluation or credentialing systems.
Preferred qualifications:
School/College/Division:
H06 - School of Medicine
Primary department:
H0621 - Ophthalmology, Visual and Anatomical Sciences
Employment type:
+ Regular Employee
+ Job type: Full Time
+ Job category: Staff/Administrative
Funding/salary information:
+ Compensation type: Annual Salary
+ Hourly rate:
+ Salary minimum: TBD
+ Salary hire maximum: TBD
Working conditions:
This position is 40 hours per week and requires an in-office presence at Kresge Eye Institute. Some early morning or evening hours may be required during peak academic or event planning periods. Normal office environment.
Job openings:
+ Number of openings: 1
+ Reposted position: No
+ Reposted reason: None (New Requisition)
+ Prior posting/requisition number:
Background check requirements:
University policy requires certain persons who are offered employment to undergo a background check, including a criminal history check, before starting work. If you are offered employment, the university will inform you if a background check is required.
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