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Manager Adjudication Jobs in Michigan (NOW HIRING)

CVS Health

MI · On-site

$17 - $34.15/hr

The Adjudication Associate (Omnicare) is responsible for the preparation and submission of claims ... Experience in pharmacy, managed care, Medicaid and/or Medicare organizations. * Ability to perform ...

TIC Midwest, LLC

Pension Plan Manager

Lansing, MI · On-site

Manage the end-to-end administration of pension plans, including plan design, compliance, and ... adjudication, benefit payment, FASB ASC 965 (formerly SOP 92-6), COBRA, HIPAA, SPD's, QMCSO's or ...

Td

Risk Manager II (US)

Southfield, MI · On-site

$115K - $173K/yr

Risk Management The Risk Manager II manages the creation, implementation and validation of various risk segmentation strategies including, but not limited to: adjudication, exposure management, risk ...

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Manager Adjudication information

What is the difference between Manager Adjudication vs Claims Supervisor?

AspectManager AdjudicationClaims Supervisor
CredentialsTypically requires insurance or healthcare certifications, relevant degreesSimilar credentials, often with insurance or healthcare background
Work EnvironmentOffice-based, insurance or healthcare settingOffice-based, insurance or healthcare setting
Industry UsageCommon in insurance, healthcare, and claims processingCommon in insurance, healthcare, and claims departments
Primary FocusReviewing and approving claims, making adjudication decisionsOverseeing claims processing, managing claims staff

While both roles operate within the insurance and healthcare industries, the Manager Adjudication primarily focuses on reviewing and making decisions on claims, whereas the Claims Supervisor manages the claims team and oversees the claims process. Both roles require similar credentials and work environments, but their core responsibilities differ in scope and focus.

What are some common challenges faced by a manager adjudication, and how can they be addressed?

A Manager Adjudication often faces challenges such as managing high volumes of complex cases, ensuring consistent and fair decision-making, and keeping up with changing regulations or organizational policies. Balancing efficiency while maintaining accuracy can be demanding, especially when deadlines are tight. These challenges can be addressed by implementing robust training programs for staff, leveraging technology for workflow management, and fostering clear communication within the team to ensure everyone is aligned on best practices and updates.

What are the roles and responsibilities of a manager adjudication?

A Manager Adjudication oversees the process of reviewing and making decisions on claims, disputes, or applications, often within insurance, healthcare, or government sectors. Their responsibilities include managing a team of adjudicators, ensuring compliance with policies and regulations, reviewing complex cases, and implementing process improvements. They also provide training and support to staff, handle escalated cases, and work to streamline adjudication procedures for efficiency and fairness.

What are the key skills and qualifications needed to thrive as a manager adjudication?

To thrive as a Manager Adjudication, you need strong analytical skills, deep knowledge of claims processing, and typically a bachelor’s degree in business, healthcare administration, or a related field. Familiarity with adjudication software, claims management systems, and regulatory compliance tools is essential. Leadership, effective communication, and problem-solving abilities are crucial soft skills for managing teams and complex case reviews. These competencies ensure accurate, timely claims decisions and maintain compliance with industry standards, directly impacting organizational efficiency and client satisfaction.
What are popular job titles related to Manager Adjudication jobs in Michigan? For Manager Adjudication jobs in Michigan, the most frequently searched job titles are:
What job categories do people searching Manager Adjudication jobs in Michigan look for? The top searched job categories for Manager Adjudication jobs in Michigan are:
What cities in Michigan are hiring for Manager Adjudication jobs? Cities in Michigan with the most Manager Adjudication job openings:
Manager Adjudication jobs near you
Infographic showing various Manager Adjudication job openings in Michigan as of June 2026, with employment types broken down into 94% Full Time, and 6% Contract. Highlights an 100% In-person job distribution.

Adjudication Associate (Omnicare) - Overnight

CVS Health

MI • On-site

$17 - $34.15/hr

Other

Medical, Dental, Vision, Retirement, PTO

This job post has expired today. Applications are no longer accepted.

CVS Health rating

5.8

Company rating: 5.8 out of 10

Based on 4,329 frontline employees who took The Breakroom Quiz

88th of 111 rated pharmacies

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

Omnicare is a leading provider of pharmacy services to long-term care facilities nationwide, supporting skilled nursing facilities, assisted living communities, and other institutional care settings. As we transition to an independent, standalone organization, we are building and strengthening internal capabilities to support our approximately 6,000 colleagues and multi-state operations.

The Adjudication Associate (Omnicare) is responsible for the preparation and submission of claims for accounts to ensure timely reimbursements. This person will communicate with the nursing facility staff, physician offices, and insurance companies to maintain payment deliverables for online claim submissions.

Required Qualifications

  • At least 1 year of experience in a pharmacy-based environment.

  • Basic proficiency with desktop software applications, particularly Microsoft Excel and Microsoft Access.

  • Must be able to work overnight, as well as work weekends and holidays on a rotating schedule.

Preferred Qualifications

  • Pharmacy technician certification.

  • Experience in pharmacy, managed care, Medicaid and/or Medicare organizations.

  • Ability to perform multiple tasks effectively.

  • Ability to work both independently and as part of a team.

Education

  • High School Diploma or GED.

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The typical pay range for this role is:

$17.00 - $34.15

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 (https://learn.bswift.com/cvshealth-mainland) .

We anticipate the application window for this opening will close on: 08/03/2026

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

CVS Health is an equal opportunity/affirmative action employer, including Disability/Protected Veteran — committed to diversity in the workplace.

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