Title: Grievance & Appeals Nurse (RN) Job Responsibilities: - Investigate and process medical necessity appeals requests from members and providers. - Support legal, management, and executive leadership in managing State Fair Hearing and External Medical Review requests. - Act as a resource for clinical...
ACA, ERISA, the Code, HIPAA, and COBRA. - Develop and... present materials on various health and welfare compliance-related issues to internal sales teams and external clients. - Establish effective working relationships with internal partners, clients, and carriers. - Function as part of a...
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...
Title: Senior Corporate Counsel - Benefits Job Responsibilities: - Provide legal guidance and strategic support for the company's . employee benefit plans and programs, ensuring compliance with applicable laws and regulations. - Advise Benefits and other internal teams on the design, administration, and...
The following jobs are no longer active but were real openings previously posted by employers. These listings provide valuable insight into employer hiring trends and frequently lead to job offers. In many cases, employers are still hiring or open to strong candidates even if no new job is posted. Applying to these listings often makes you the only applicant, increasing your chances of being hired.
/ Compliance Specialist The candidate will coordinate with various internal departments and committees to develop processes and document, manage, and monitor policies and procedures to ensure operational and procedural compliance with state and federal regulations. Will work closely with legal departments and translate legal requirements/regulations and facilitate risk assessments to highlight compliance process vulnerabilities. Recommend and build new policies and p... read more
Note: This job is no longer active. It was originally posted on [Date] and is part of LawCrossing’s historical archive of legal jobs. While the position may have been filled, employers often remain open to exceptional candidates for similar roles. LawCrossing has tracked this employer's hiring activity for over 25 years. This listing is provided for informational and outreach purposes and may still lead to employment. Learn more about archive jobs and how powerful they are for your search, click here
Counsel, Regulatory FDA Duties: Works with the Senior Vice President of QA/Regulatory Affairs and assists him or her in establishing comprehensive regulatory strategies and programs for Invacare and provides legal counsel, analysis and advice to the company on legal-regulatory issues. Monitors and tracks proposed healthcare-related regulations and policies that will impact the company’s businesses, with a special focus on FDA regulations. Advises, counsels and act... read more
Note: This job is no longer active. It was originally posted on [Date] and is part of LawCrossing’s historical archive of legal jobs. While the position may have been filled, employers often remain open to exceptional candidates for similar roles. LawCrossing has tracked this employer's hiring activity for over 25 years. This listing is provided for informational and outreach purposes and may still lead to employment. Learn more about archive jobs and how powerful they are for your search, click here
Audit and Reimbursement II The candidate performs audit work scoped by the desk reviews and will be the in-charge auditor on small and less complex audits. Assists higher level auditor on field work and appeals as assigned. Responsible for completing interim rate reviews, tentative settlements and final settlements of providers as assigned. Performs special audits of End Stage Renal Disease (ESRD) providers and provider exception requests as assigned. Updates STAR, FISS... read more
Note: This job is no longer active. It was originally posted on [Date] and is part of LawCrossing’s historical archive of legal jobs. While the position may have been filled, employers often remain open to exceptional candidates for similar roles. LawCrossing has tracked this employer's hiring activity for over 25 years. This listing is provided for informational and outreach purposes and may still lead to employment. Learn more about archive jobs and how powerful they are for your search, click here
Associate General Counsel - Healthcare Privacy The candidate should have a . degree from an ABA accredited law school. Current license to practice law is required. Must have 8-10 years of experience in the area of healthcare privacy law. Substantial background in state and federal privacy laws, including HIPAA Privacy and Security rules... required. Certified Information Privacy Professional (CIPP) certification or other comparable privacy professional certification (or will... read more
Note: This job is no longer active. It was originally posted on [Date] and is part of LawCrossing’s historical archive of legal jobs. While the position may have been filled, employers often remain open to exceptional candidates for similar roles. LawCrossing has tracked this employer's hiring activity for over 25 years. This listing is provided for informational and outreach purposes and may still lead to employment. Learn more about archive jobs and how powerful they are for your search, click here
VP Payment Innovation Reporting/Tools and Payment Models Duties: Develop total value payment models that incentivize improvements in health care quality and outcomes while reducing unnecessary cost and resource use associated with care delivery. Oversee the complementary tools and applications that support population health management, and make cost and quality information available to physicians and their patients. Leads the development and maintenance of shared savin... read more
Note: This job is no longer active. It was originally posted on [Date] and is part of LawCrossing’s historical archive of legal jobs. While the position may have been filled, employers often remain open to exceptional candidates for similar roles. LawCrossing has tracked this employer's hiring activity for over 25 years. This listing is provided for informational and outreach purposes and may still lead to employment. Learn more about archive jobs and how powerful they are for your search, click here
VP Payment Mdls/Analytical Reporting Duties: Will be responsible for leading the development of payment models to support migration from volume to value based contracting. This position has end-to-end financial and analytical accountability for company's value-based payment models (., shared savings/shared risk, bundle payment, pay for performance). As the healthcare industry continues to transform, moving away from traditional fee-for-service reimbursement, this ro... read more
Note: This job is no longer active. It was originally posted on [Date] and is part of LawCrossing’s historical archive of legal jobs. While the position may have been filled, employers often remain open to exceptional candidates for similar roles. LawCrossing has tracked this employer's hiring activity for over 25 years. This listing is provided for informational and outreach purposes and may still lead to employment. Learn more about archive jobs and how powerful they are for your search, click here
VP Payment Models, Analytics and Reporting Duties: Responsible for leading the development of payment models to support migration from volume to value based contracting. Position has end-to-end financial and analytical accountability for the company’s value-based payment models (., shared savings/shared risk, bundle payment, pay for performance). As the healthcare industry continues to transform, moving away from traditional fee-for-service reimbursement, this rol... read more
Note: This job is no longer active. It was originally posted on [Date] and is part of LawCrossing’s historical archive of legal jobs. While the position may have been filled, employers often remain open to exceptional candidates for similar roles. LawCrossing has tracked this employer's hiring activity for over 25 years. This listing is provided for informational and outreach purposes and may still lead to employment. Learn more about archive jobs and how powerful they are for your search, click here
Counsel or Legal Counsel Senior Candidate will be responsible for helping provide legal support on healthcare privacy and related data security issues.... read more
Note: This job is no longer active. It was originally posted on [Date] and is part of LawCrossing’s historical archive of legal jobs. While the position may have been filled, employers often remain open to exceptional candidates for similar roles. LawCrossing has tracked this employer's hiring activity for over 25 years. This listing is provided for informational and outreach purposes and may still lead to employment. Learn more about archive jobs and how powerful they are for your search, click here
General Counsel The candidate will be responsible for providing legal advice and recommendations for initiatives and projects developed in response to Pharmacy clients overall objectives and needs. Focus of work is on large scale and/or high financial level Pharmacy projects with broad department and/or organizational impact and moderate level of risk. Will work as a strategic partner and decision maker with Pharmacy clients and more senior leaders, and manages wor... read more
Note: This job is no longer active. It was originally posted on [Date] and is part of LawCrossing’s historical archive of legal jobs. While the position may have been filled, employers often remain open to exceptional candidates for similar roles. LawCrossing has tracked this employer's hiring activity for over 25 years. This listing is provided for informational and outreach purposes and may still lead to employment. Learn more about archive jobs and how powerful they are for your search, click here
VP, Program Integrity / Investigations The candidate will provide leadership to the Commercial Special Investigations Unit, Provider Audit and Data Mining teams. Primary duties include: development and implementation of program strategies, goals, deliverables, and overall program execution. Develop and administer a strategy that continually reduces the inappropriate provider payments and optimizes opportunities to drive fraud, waste and abuse savings including identify... read more
Note: This job is no longer active. It was originally posted on [Date] and is part of LawCrossing’s historical archive of legal jobs. While the position may have been filled, employers often remain open to exceptional candidates for similar roles. LawCrossing has tracked this employer's hiring activity for over 25 years. This listing is provided for informational and outreach purposes and may still lead to employment. Learn more about archive jobs and how powerful they are for your search, click here