Top 48 Researcher Jobs in East Lansing, Mi

Professional Review Data Researcher
Delta Dental of Michigan —Okemos, MI
- Full-time
- Hybrid work
- Computer Science
- Research
- Mid-level
- Dental insurance
- Opportunities for advancement
Lab Manager/Research Assistant II
Michigan State University —East Lansing, MI
- $56,734 - $70,000 a year
- Full-time
- Computer literacy
- Mid-level
- University
9d
Information Technologist II
Michigan State University —East Lansing, MI
- $75,000 - $90,000 a year
- Full-time
- Hybrid work
- Computer science
- Computer Science
- Mid-level
9d
Professional Aide
Michigan State University —East Lansing, MI
- Temporary
- Remote
- Management
- Entry level
14d
Planner/Inspector/Analyst III
Michigan State University —East Lansing, MI
- $100,200 - $122,400 a year
- Weekends as needed
- Hybrid work
- Construction site
- Driver's License
- Bachelor's degree
- Health insurance
9d
Research Associate-Fixed Term
Michigan State University —East Lansing, MI
- Full-time
- Civil engineering
- Analysis skills
- University
Specialist - Curriculum Dev-Continuing
Michigan State University —East Lansing, MI
- $80,000 - $110,000 a year
- Full-time
- Master's degree
- University
- Doctor of Philosophy
Social Worker
US Veterans Health Administration —Lansing, MI
- $70,459 - $110,830 a year
- Online Application
- Background check
- Master of Social Work
- Doctoral degree
- Paid parental leave
- Paid holidays
8d
Specialist - Research-Continuing
Michigan State University —East Lansing, MI
- $75,000 - $90,000 a year
- Full-time
- University
- Doctor of Philosophy
- Criminal background check
Communications Director
Corn Marketing Program of Michigan —DeWitt, MI
- $70,000 - $78,000 a year
- Email
- Hybrid work
- Background check
- Microsoft Outlook
- Marketing
- Health savings account
- Paid holidays
Quick Apply
11h
Per Diem Clinical Research Nurse - Home Visits
Science 37 —Lansing, MI
- $50 - $55 an hour
- Nights as needed
- Nursing
- RN License
- BLS Certification
Assistant Professor-Tenure System
Michigan State University —East Lansing, MI
- Full-time
- University
- Doctor of Philosophy
- Senior level
Chairperson-Management
Michigan State University —East Lansing, MI
- Full-time
- University
- Doctor of Philosophy
- Critical & Intensive Care
Postdoctoral Scholar-Fixed Term
Michigan State University —East Lansing, MI
- Full-time
- High school
- University
- Education
11d
Business & Human Resources Administrator / Administrative Business Prof/S
Michigan State University —East Lansing, MI
- Full-time
- Word processing
- Finance
- Analysis skills
2d
Audiologist
US Veterans Health Administration —Lansing, MI
- $89,508 - $116,362 a year
- Part-time
- Background check
- Doctoral degree
- Writing skills
8d
AVP for Research Infrastructure/Capacity Building
Michigan State University —East Lansing, MI
- Full-time
- University
- Doctor of Philosophy
- Criminal background check
Associate/Full Professor
Michigan State University —East Lansing, MI
- Full-time
- Remote
- Nursing
- RN License
- University
Senior Director of Devel, CommArtsSci / Development Officer III/S
Michigan State University —East Lansing, MI
- Full-time
- Marketing
- Driver's License
- University
9d
Ast Prof/Asc Prof Fixed Term
Michigan State University —East Lansing, MI
- Online Application
- University
- Doctor of Philosophy
- Psychology

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researcher jobs near east lansing, mi

Professional Review Data Researcher

Delta Dental of Michigan -
Okemos, MI

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Job Details

Full-time

Benefits

Dental insurance
Opportunities for advancement

Qualifications

Spreadsheets
Business intelligence tools
Health insurance knowledge
Data analysis software
Database software proficiency

Full Job Description

Job Title:

Professional Review Data Researcher

Number of Positions:

Location:

Okemos, MI

Location Specifics:

Hybrid Position

Job Summary:

At Delta Dental of Michigan, Ohio, and Indiana we work to improve oral health through benefit plans, advocacy and community support, and we amplify this mission by investing in initiatives that build healthy, smart, vibrant communities. We are one of the largest dental plan administrators in the country, and are part of the Delta Dental Plans Association, which operates two of the largest dental networks in the nation.

At Delta Dental, we celebrate our All In culture. It’s a mindset, feeling and attitude we wrap around all that we do – from taking charge of our careers, to helping colleagues and lending a hand in the community.

Position Description:

To administer data driven activities by transforming raw data into actionable information.

Primary Job Responsibilities:

Designs, develops, validates, and deploys data-driven analytics, predictive models, reporting solutions, and end-to-end analytical research to support Professional Review program integrity initiatives, including defining objectives, selecting and evaluating data sources, determining methodologies, performing analysis and testing, conducting quality assurance, and interpreting findings.
Investigates internal and external referrals, performs provider research and preliminary investigative reviews, substantiates referral activity, documents work in the appropriate case management system, and analyzes provider billing, utilization, and treatment patterns to identify outliers, emerging trends, potential fraud, waste, and abuse activity, and other areas requiring monitoring or intervention.
Develops recommendations regarding provider placement on or removal from Focused Review; maintains associated provider status, tracking, documentation, and follow-up records; and prepares and sends welcome and removal letters and related provider communications.
Creates, maintains, and enhances dashboards, databases, monitoring reports, analytic tools, scripts, and repeatable processes that support operational oversight, program integrity initiatives, performance measurement, leadership decision-making, recurring reporting, and automated analytical workflows.
Collects, transforms, cleanses, validates, organizes, troubleshoots, and resolves data, reporting, database, and system issues to support analysis-ready data, consistent definitions across sources, and data availability, usability, integrity, and reporting effectiveness.
Tracks, analyzes, and reports on denial trends, overpayments, provider performance metrics, fraud, waste, and abuse activity, and other key program integrity indicators while supporting program integrity initiatives, audits, regulatory requests, RFP responses, and special projects through data gathering, analysis, response preparation, and recommendations.
Serves as a consultant and subject matter resource for internal and external stakeholders by translating business needs, reporting questions, research requests, needs assessments, case studies, and related analytic deliverables into clear insights that support monitoring activities, operational improvement, and strategic decision-making.
Leads or supports Special Investigations Unit and program integrity meetings by developing agendas, documenting meeting minutes, reviewing provider billing and treatment patterns, and tracking follow-up items through completion.

#LI-Hybrid

Minimum Requirements:

Position requires a bachelor's degree in computer science, information systems, business administration or a related field and three years of experience performing data analytics in a business setting. Will accept any suitable combination or education, training, or experience.

Position requires general knowledge of insurance business, the claims processing system and other business applications; the ability to use data extraction and analysis tools, such as Microsoft Excel, Access, PowerPoint, Oracle Discoverer, ACL and others; strong communication skills; and the ability to resolve problems and use independent judgment.

The company will provide equal employment and advancement opportunity within the context of its unique business environment without regard to race, color, religion, gender, gender identity, gender expression, age, national origin, familial status, citizenship, genetic information, disability, sex, sexual orientation, marital status, pregnancy, height, weight, military status, or any other status protected under federal, state, or local law or ordinance.

Apply Now

Refine Your Search

researcher jobs in east lansing, mi

Professional Review Data Researcher

Lab Manager/Research Assistant II

Information Technologist II

Professional Aide

Planner/Inspector/Analyst III

Research Associate-Fixed Term

Specialist - Curriculum Dev-Continuing

Social Worker

Specialist - Research-Continuing

Communications Director

Per Diem Clinical Research Nurse - Home Visits

Assistant Professor-Tenure System

Chairperson-Management

Postdoctoral Scholar-Fixed Term

Business & Human Resources Administrator / Administrative Business Prof/S

Audiologist

AVP for Research Infrastructure/Capacity Building

Associate/Full Professor

Senior Director of Devel, CommArtsSci / Development Officer III/S

Ast Prof/Asc Prof Fixed Term

I want to receive the latest job alert for researcher in east lansing, mi

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