ensuring compliance with applicable laws and regulations. - Advise Benefits and other internal teams on the design, administration, and compliance of . employee benefit plans, including 401(k) plans, health & welfare plans, fringe... benefit programs, nonqualified deferred compensation plans, and leave...
Title: Grievance & Appeals Nurse (RN) Job Responsibilities: The Grievance & Appeals Nurse (RN) is responsible for managing and processing medical necessity appeals requests from members and providers. Key responsibilities include: - Supporting legal, management, and executive leadership by overseeing State Fair Hearing...
executive leadership in managing State Fair Hearing and External Medical Review requests. - Act as a resource for clinical and non-clinical teams by conducting thorough investigations and reviews of medical necessity appeals in preparation for litigation. - Document and log appeal... information...
Title: Paralegal I Job Responsibilities: - Research and analyze legal sources including statutes, judicial decisions, and legal articles to effectively respond to subpoenas served upon any entity within the company group of companies. - Collect, review, redact, categorize (e-tag), and produce...
governance of information technology systems (ISD) and artificial intelligence within a hospital setting. - Advise hospital leadership and procurement teams on the legal implications of acquiring new technologies, including electronic health records (EHR), telemedicine platforms,... cybersecurity tools, and medical devices. - Draft,...