2 legal jobs found in Detroit

COMPLIANCE SPECIALIST Under the general supervision of the Vice President of Compliance & Privacy Officer, the Compliance Specialist is responsible for conducting investigations and audits related to fraud, waste, and abuse within the DWIHN provider network. This role includes performing targeted reviews, gathering and analyzing information, and applying relevant regulations, policies, and internal controls to assess compliance. The Compliance Specialist also supports the implementation of policies, procedures, and control measures to ensure that DWIHN and its providers adhere to applicable regulatory and ethical standards.   PRINCIPAL DUTIES AND RESPONSIBILITIES: Conduct FWA Investigations:   Manage investigations related to suspected fraud, waste, and abuse within the provider network. Data Gathering & Analysis:   Collect, review, and analyze relevant documents, data, claims, medical records, and other evidence to assess compliance...

PSYCHIATRIST Under the general supervision of the Chief Medical Director, the Psychiatrist employee will function as the Clinical Psychiatrist for DWIHN’s Crisis Care Center or Direct Outpatient Clinics. The Psychiatrist will provide medical direction, guidance, planning, and supervision for all crisis or outpatient behavioral health programs and provide quality care to DWIHN members.   PRINCIPAL DUTIES AND RESPONSIBILITIES: Performs all duties and responsibilities required of a psychiatrist and provides quality and cost-effective care for the designated patient population in accordance with accepted medical standards and protocols. Performs psychiatric evaluations, re-evaluations, medication authorization, follow-up visits, and coordination with treatment teams. Performs primary care treatment and evaluation. Performs care and evaluations for clients with substance use disorders and individuals with dual diagnosis. Ensures timely documentation...