Top 38 Claims manager Jobs in Lansing, Mi

Case Manager Registered Nurse (LTSS) - Field MI (Southwest Michigan)
CVS Health —Lansing, MI
- $60,522 - $129,615 a year
- Full-time
- Bilingual
- Nursing
- Microsoft Outlook
- Health insurance
- Dental insurance
Case Manager Registered Nurse (LTSS) - Field MI (Wayne and Macomb County)
CVS Health —Lansing, MI
- $60,522 - $129,615 a year
- Full-time
- Bilingual
- Nursing
- Microsoft Outlook
- Health insurance
- Dental insurance
Card Fraud Manager
MSU Federal Credit Union —East Lansing, MI
- From $90,000 a year
- Monday to Friday
- Hybrid work
- Computer literacy
- Mid-level
- Office
- Paid parental leave
- Paid holidays
Quick Apply
Senior Manager, Pharma Support Services - Remote
Option Care Enterprises, Inc. —Lansing, MI
- $78,973.32 - $131,614.70 a year
- Full-time
- High school diploma or GED
- Travel
- Senior level
- Health savings account
- Health insurance
Quick Apply
19h
Supervisor, Focused Review
Delta Dental of Michigan —Okemos, MI
- Full-time
- Hybrid work
- 5 years
- Word processing
- Research
- Dental insurance
- Opportunities for advancement
Account Manager
Populist Cleaning Company —Lansing, MI
- $24 - $28 an hour
- Full-time
- Mid-level
- 3 years
- Driver's License
Quick Apply
UMH Sparrow Health System - Manager of Denials, Audits & Appeals
University of Michigan Health Sparrow —Lansing, MI
- Full-time
- Hospital
- HIPAA
- Finance
Lead Director - Grievance & Appeals - PMO Lead
CVS Health —Lansing, MI
- $100,000 - $231,540 a year
- Full-time
- Bachelor's degree
- Fair chance
- Senior level
- Health insurance
- Dental insurance
4d
Manager, Loss Control
Michigan Millers Mutual Insurance Company —Lansing, MI
- $106,685 - $152,570 a year
- Full-time
- Clean driving record
- Research
- Business development
- Wellness program
- Paid parental leave
Quick Apply
Senior Account Manager (Fully Remote)
Insurance Office of America, Inc. —Lansing, MI
- $80,000 - $100,000 a year
- Full-time
- Microsoft Outlook
- 5 years
- Research
- Paid holidays
- Health insurance
Quick Apply
Senior Account Manager - Commercial Lines
Insurance Office of America, Inc. —Lansing, MI
- $80,000 - $100,000 a year
- Full-time
- Microsoft Outlook
- 5 years
- Research
- Paid holidays
- Health insurance
Quick Apply
Account Manager - Commercial Insurance (Construction / Contractors)
IOA National, Inc. —Lansing, MI
- $65,000 - $80,000 a year
- Full-time
- Microsoft Outlook
- Research
- Mid-level
- Paid holidays
- Health insurance
Quick Apply
Regional Sales Manager
Essentra —Lansing, MI
- Computer literacy
- Windows
- Microsoft Office
- Paid time off
3d
Senior Account Manager- Commercial Insurance (Remote)
Insurance Office of America, Inc. —Lansing, MI
- $80,000 - $95,000 a year
- Full-time
- Microsoft Outlook
- 5 years
- Research
- Paid holidays
- Health insurance
Quick Apply
17h
Commercial Insurance Account Manager - Trucking
Insurance Office of America, Inc. —Lansing, MI
- $70,000 - $90,000 a year
- Full-time
- Microsoft Outlook
- Research
- Mid-level
- Paid holidays
- Health insurance
Quick Apply
Personal Lines Account Manager
Insurance Office of America, Inc. —Lansing, MI
- $45,000 - $55,000 a year
- Full-time
- Microsoft Outlook
- 5 years
- High school diploma or GED
- Paid holidays
- Health insurance
Quick Apply
6d
Personal Lines Account Manager
Diversified Insurance Group, Inc —Lansing, MI
- $40,000 - $50,000 a year
- Full-time
- Google Workspace
- Writing skills
- Mid-level
- Health insurance
- Dental insurance
Quick Apply
Account Manager Associate - Commercial Lines
Insurance Office of America, Inc. —Lansing, MI
- $55,000 - $65,000 a year
- Full-time
- 7 years
- Microsoft Outlook
- Word processing
- Paid holidays
- Health insurance
Quick Apply
10d
Account Manager- Commercial Insurance
Insurance Office of America, Inc. —Lansing, MI
- $45,000 - $75,000 a year
- Full-time
- Mid-level
- Leadership
- 2 years
- Paid holidays
- Health insurance
Quick Apply
Customer Service Manager - State Farm Agent Team Member
David Bevins - State Farm Agent —Holt, MI
- $30,000 - $50,000 a year
- Full-time
- Office
- Communication skills
- Entry level
- Paid time off
- Opportunities for advancement
Quick Apply

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Case Manager Registered Nurse (LTSS) - Field MI (Southwest Michigan)

CVS Health -
Lansing, MI

Apply Now

Job Details

Full-time
$60,522 - $129,615 a year

Benefits

Health insurance
Dental insurance
Paid time off
Vision insurance

Qualifications

Electronic health records (EHR) management
RN License
Community resource coordination in health services social work
Care planning in social services
Managing patient records
Home & community care experience

Full Job Description

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.

Position Summary

Location: Work From Home – Flexible, Travel Required: 25 – 50% (Barry, Van Buren, Kalamazoo, Calhoun, Branch, St Joseph, Cass, and Berrien Counties)
Schedule: Standard business hours Monday-Friday 8:00am-5:00pm EST
No evenings, weekends, or major holidays
4 day/10-hour schedule available after training

Our Mission

The LTSS RN Case Manager is responsible for comprehensive assessment, care planning, coordination, implementation, and monitoring of Long-Term Services and Supports (LTSS) for dual-eligible Medicare and Medicaid members. This role ensures members receive appropriate waiver and community-based services to promote safety, independence, and improved health outcomes while maintaining regulatory compliance. This position includes in-home visits to complete functional assessments, evaluate eligibility for waiver services, and develop person-centered service plans.

Join our Aetna team as an industry leader in serving dual eligible populations by utilizing best-in-class operating and clinical models. You can have life-changing impact on our members who are enrolled in Medicare and Medicaid and present with a wide range of complex health and social challenges. With compassionate attention and excellent communication, we collaborate with members, providers, and community organizations to address the full continuum of our members’ health care and social determinant needs. Join us in this exciting opportunity as we grow and expand dually eligible members to change lives in new markets across the country. Position Summary/Mission Our Care Managers are frontline advocates for members who cannot advocate for themselves. They are responsible for assessing, planning, implementing, and coordinating all case management activities with members to evaluate the medical needs of the member to facilitate the member’s overall wellness.

Key Responsibilities

Conduct comprehensive in-home LTSS assessments to determine eligibility for waiver and community-based services.
Complete and submit required waiver documentation in accordance with state Medicaid and health plan guidelines.
Develop and implement individualized, person-centered plans of care addressing medical, behavioral, functional, and social determinant needs.
Apply clinical judgment to identify risk factors, prevent avoidable hospitalizations, and reduce barriers to care.
Coordinate services across interdisciplinary teams including providers, home health agencies, behavioral health, and community organizations.
Review claims data, clinical records, and assessment tools to evaluate member needs and benefit utilization.
Monitor member progress and reassess needs based on changes in condition or level of care.
Present cases at interdisciplinary team (ICT) meetings and collaborate with supervisors and stakeholders to ensure goal attainment.
Ensure compliance with Medicaid waiver requirements, CMS regulations, state LTSS guidelines, and company policies.
Document all case management activities in accordance with regulatory and accreditation standards.
Educate members and caregivers regarding benefits, services, and available community resources.

Remote Work Expectations

This is a remote role with 25-50% travel required, candidates must have a dedicated workspace free of interruptions.
Dependents must have separate care arrangements during work hours, as continuous care responsibilities during shift times are not permitted.

Required Qualifications

Active, unrestricted Registered Nurse (RN) license in the state of Michigan.
Associate or Bachelor of Science in Nursing (BSN preferred).
Minimum of 2 years of clinical nursing experience.
Minimum of 1 year of experience in case management, care coordination, home health, hospice, or long-term care.
Experience working with Medicare, Medicaid, or dual-eligible populations.
Knowledge of Long-Term Services and Supports (LTSS), home and community-based services (HCBS), and waiver programs.
Experience conducting in-home assessments and developing person-centered service plans.
Strong understanding of social determinants of health and community resource navigation.
Ability to travel 25–50% within assigned counties, including completion of in-home field visits; reliable transportation is required.
Proficient in electronic medical records and care management platforms.

Preferred Qualifications

Certified Case Manager (CCM) or willingness to obtain within 2 years.
Experience in managed care or health plan environment.
Knowledge of Michigan Medicaid waiver programs and state LTSS regulations.
Experience presenting cases in interdisciplinary team (ICT) settings.
Bilingual skills preferred.

Competencies

Strong clinical assessment and critical thinking skills
Excellent communication and member engagement skills
Ability to manage a high-risk, complex caseload
Regulatory and compliance knowledge
Independent decision-making in a remote environment
Ability to work independently
Effective computer skills including navigating multiple systems and keyboarding
Demonstrates proficiency with standard corporate software applications, including MS Word, Excel, Outlook, and PowerPoint

Business Overview

At Aetna, a CVS Health company, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.

We are committed to maintaining a diverse and inclusive workplace. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, gender, gender identity, age, disability or protected veteran status. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.

Anticipated Weekly Hours

Time Type

Full time

Pay Range

The typical pay range for this role is:

$60,522.00 - $129,615.00

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors.

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Great benefits for great people

We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.

This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.

Additional details about available benefits are provided during the application process and on Benefits Moments.

This job does not have an application deadline, as CVS Health accepts applications on an ongoing basis.

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Apply Now

Refine Your Search

claims manager jobs in lansing, mi

Case Manager Registered Nurse (LTSS) - Field MI (Southwest Michigan)

Case Manager Registered Nurse (LTSS) - Field MI (Wayne and Macomb County)

Card Fraud Manager

Senior Manager, Pharma Support Services - Remote

Supervisor, Focused Review

Account Manager

UMH Sparrow Health System - Manager of Denials, Audits & Appeals

Lead Director - Grievance & Appeals - PMO Lead

Manager, Loss Control

Senior Account Manager (Fully Remote)

Senior Account Manager - Commercial Lines

Account Manager - Commercial Insurance (Construction / Contractors)

Regional Sales Manager

Senior Account Manager- Commercial Insurance (Remote)

Commercial Insurance Account Manager - Trucking

Personal Lines Account Manager

Personal Lines Account Manager

Account Manager Associate - Commercial Lines

Account Manager- Commercial Insurance

Customer Service Manager - State Farm Agent Team Member

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