Title: Grievance & Appeals Nurse (RN) Job Responsibilities: - Investigate and process medical necessity appeals requests from members and providers. - Support legal, management, and executive leadership by managing State Fair Hearing and External Medical Review requests. - Act as...
Title Senior Legal Counsel I Job Responsibilities - Provides legal advice and counsel to corporate officers, managers, and employees of the Company and its subsidiaries, affiliates, and joint ventures across various lines of business under the general direction of Legal...
Title: Grievance & Appeals Nurse (RN) Job Responsibilities: - The Nurse Appeals is responsible for investigating and processing medical necessity appeals requests from members and providers. - Supports legal, management, and executive leadership by managing State Fair Hearing and External Medical Review requests. -...
The following jobs are no longer active but were real openings previously posted by employers.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.
and Compliance Officer Duties: Provide leadership, direction and oversight of Integrity and Compliance Program (ICP). Ensure has established systems, policies and procedures to effectively comply with applicable laws and regulations pertaining to its business activities, including those pertaining to federal and state health care programs. Provides oversight and leadership to the operations of Mount Carmel's Integrity and Compliance Program (ICP) in accordance with... 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Note: This job is no longer active.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 Responsibilities : The candidate will know, understand, incorporate and demonstrate the mission, vision and values of firm and assigned RHM in leadership behaviors, practices and decisions. Provides legal counsel to assigned RHM and its operating entities with respect to matters in the field of corporate healthcare law. Meets routinely with the supervisor to establish priorities and manage expectations for the delivery of legal services at the assigned RHM.... 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 The candidate will be responsible for supporting strategic initiatives, product development and overseeing the technology licensing work for the business and managing members of the contracting legal team. Must have 10+ years of experience providing legal counsel to clients. Must have comprehensive commercial contract drafting and negotiation skills. In-depth legal knowledge that allows for expeditious problem identificaation and resolution is essential. Shoul... 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 The candidate will provide responsibilities include: Drafts, reviews, and edits a wide range of commercial contracts for the company. Assist with company compliance with existing regulatory and contractual obligations (CMS, HIPAA and Federal/State Privacy Laws, Respective State Insurance Regulations). Consults on an ongoing basis on related issues with operations managers and executives regarding applicable laws and regulations, including, HIPAA, Federal/S... 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
Care Regional Expansion Consultant - Central / Western Region Duties: The candidate develops and executes strategies for a function or discipline that span a large business unit or multiple markets/sites. Directs others to resolve business problems that affect multiple functions or disciplines. Product, service or process decisions are most likely to impact multiple functions and/or customer accounts (internal or external). Develops, maintains, and executes Complex C... 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
Care Expansion Consultants (State level) The candidate develops and executes strategies for a function or discipline that span a large business unit or multiple markets/sites. Directs others to resolve business problems that affect multiple functions or disciplines. Responsible for achieving growth goals. Develops, maintains, and executes Complex Care market expansion strategies for region. Serves as technical expert for Complex Care Products to state governments, in... 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
Legal Analyst The candidate will research government regulations and guidance on the health care industry, including on PBM operations. Will summarize and communicate regulations to management and other internal stakeholders. Utilize various hardcopy and electronic resources to research health care and related regulations. Identify laws and regulations that affect PBM operations, including those related to Medicare, Medicaid, and the Patient Protection... and Affordable Care Ac... 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
Director of Billing Compliance - UC Health Business Center - Corporate Compliance Duties: Will assist company and its entities to provide care and to conduct business in accordance with applicable medicare and medicaid coding, billing and reimbursement... regulations and direct a comprehensive annual schedule of compliance auditing and monitoring reviews as well as special compliance audit requests throughout company. Develop and manage the overall billing compliance plan 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
Director of Billing Compliance - UC Health Business Center - Corporate Compliance Duties: Will assist company and its entities to provide care and to conduct business in accordance with applicable medicare and medicaid coding, billing and reimbursement... regulations and direct a comprehensive annual schedule of compliance auditing and monitoring reviews as well as special compliance audit requests throughout company. Develop and manage the overall billing compliance plan 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
Program Director - Strategic Medicaid Partnerships The candidate will... identify, design and implement strategic partnerships with a wide range of organizations to expand and enhance capabilities to support the Medicaid business and long-range Growth... plan. Will apply knowledge about the unique needs of specialized service populations (including people with intellectual and developmental disabilities, children in foster care, people with serious mental illness or other disabili... 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