Title: Pharmacy Investigator Lead Job Responsibilities: - Provide leadership and guidance to the Special Investigations Unit Pharmacy team in investigating, collecting, researching, and analyzing billing data to detect fraudulent, abusive, or wasteful activities/practices. - Assist the team manager with administration and operational activities...
Title: Legal Counsel, Carelon Contracting Job Responsibilities: The Legal Counsel for Carelon Contracting is tasked with providing legal advice and recommendations for various initiatives and projects that align with the overall objectives and needs of clients. The role involves handling large-scale and...
Title: Legal Counsel, Carelon Contracting Job Responsibilities: The Legal Counsel at Company is tasked with providing legal advice and recommendations for initiatives and projects aligned with clients' overall objectives and needs. The focus is primarily on large-scale and/or high financial level projects...
Title Legal Counsel, Carelon Contracting Job Responsibilities The Legal Counsel at Company is tasked with providing legal advice and recommendations for initiatives and projects that align with the clients' overall objectives and needs. The job focuses on large-scale and/or high...
Title: Legal Counsel, **Members Only** Contracting Job Responsibilities: The Legal Counsel is tasked with providing expert legal advice and recommendations for initiatives and projects that align with the overall objectives and needs of clients. The focus is predominantly on large-scale and/or high financial...
Title: Legal Counsel, **Members Only** Contracting Job Responsibilities: The Legal Counsel for **Members Only** Contracting is responsible for providing comprehensive legal advice and recommendations on various initiatives and projects that align with client objectives and needs. This role involves working on large-scale projects with...
Title: Legal Counsel, **Members Only** Contracting Job Responsibilities: - Negotiate and manage client contracts with health plan clients, state agencies, employer groups, and other clients of the **Members Only** Services businesses, including behavioral health, medical benefits utilization management, specialty care solutions, and...
Title: Nurse Appeals – Litigation & Legal Support Job Responsibilities: The... Nurse Appeals – Litigation & Legal Support plays... a crucial role in handling medical necessity appeals requests from members and providers. The responsibilities include: - Supporting legal, management, and executive leadership by...
Title: Nurse Appeals – Litigation & Legal Support Job Responsibilities: -... non-clinical teams by managing and conducting thorough investigations and reviews of medical necessity appeals from members and providers in preparation for litigation. - Documents and logs appeal... information in relevant tracking syste...
Title: Nurse Appeals – Litigation & Legal Support Job Responsibilities: The... Nurse Appeals – Litigation & Legal Support role... is centered around the investigation and processing of medical necessity appeals requests from members and providers. The primary duties include: - Supporting legal, management,...
Counsel (Legal Affairs & Litigation) Job Responsibilities: As a Corporate Counsel... (Legal Affairs & Litigation) at the company, the... to manage and resolve litigation-related matters that are filed... in both state and federal courts. This includes handling putative class actions, individual actions,...
Associate General Counsel - Litigation Job Responsibilities: The Associate General Counsel... counsel on complex, high-impact litigation and related projects. This... role primarily focuses on large-scale and/or high financial level projects with broad departmental and/or organizational impact and moderate risk levels. The position...
Title: Lead Counsel, Practice Management Job Responsibilities: - Serve as a principal legal advisor for CORE Ventures and The US Oncology Network, providing sophisticated, solutions-oriented guidance on a broad range of legal, regulatory, and business matters affecting oncology practice management....
Paralegal Job Title: Senior Paralegal Job Responsibilities: - Provide a variety of legal assistance and technical work requiring specialized knowledge of processes, procedures, and practices to support legal activities. - Support assignments that involve the form, content, and issues of legal instruments and documents, and...
Title: Senior Manager, Staff Counsel Job Responsibilities: The Senior Manager, Staff Counsel at the company is tasked with overseeing multiple Staff Counsel office activities related to defending lawsuits against the company's insureds in liability cases. Additionally, the role involves handling suits...
Title: Senior Manager, Staff Counsel - Virginia (Richmond, Fairfax, Roanoke, Virginia Beach) Job Responsibilities: The Senior Manager, Staff Counsel is responsible for overseeing multiple Staff Counsel office activities, focusing on the defense of lawsuits against company insureds in liability suits and...
Title: Senior Manager, Staff Counsel - Virginia Job Responsibilities: The Senior Manager, Staff Counsel is responsible for managing multiple Staff Counsel office activities related to defending lawsuits against company insureds in liability suits, as well as representing the company in subrogation,...
Title: Senior Manager, Staff Counsel Job Responsibilities: The Senior Manager of Staff Counsel at the company is responsible for managing multiple office activities related to the defense of lawsuits against insureds in liability cases and representing the company in subrogation, Uninsured...
Title: Sr. Claims Examiner/Executive Claims Examiner, Medical Malpractice Job Responsibilities: - Confirm coverage of claims by reviewing policies and documents submitted in support of claims. - Analyze coverage and communicate coverage positions. - Conduct, coordinate, and direct investigation into loss facts and extent of...