Title: Nurse Appeals (Grievance & Appeals) Job Responsibilities: The Nurse Appeals role involves investigating and processing medical necessity appeal requests from members and providers. Key responsibilities include: - Supporting legal, management, and executive leadership by managing State Fair Hearing and External Medical Review...
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: Nurse Appeals (Grievance & Appeals) Job Responsibilities: The Nurse Appeals role involves a range of responsibilities focused on managing and processing medical necessity appeals from members and providers. Key duties include: - Supporting legal, management, and executive leadership by managing State Fair...
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,...