Title: Vice President & Associate General Counsel, Clinical Operations Job Responsibilities: The Vice President & Associate General Counsel for Clinical Operations is a pivotal role within the company's Law Department, primarily tasked with advising the company's care delivery lines, specifically...
Title: Pharmacy Investigator Senior Job Responsibilities: - Independently identify, investigate, and develop complex cases against perpetrators of healthcare fraud to recover corporate and client funds paid on fraudulent claims. - Conduct claim reviews for appropriate coding, data mining, entity review, law enforcement referral,...
Title: Executive Concierge Analyst I Job Responsibilities: The Executive Concierge Analyst I, also known as the Grievance and Appeals Analyst I, plays a crucial role in responding to inquiries from regulatory agencies and executive leadership. The position involves providing support to legal,...
Title: Legal Counsel, **Members Only** Contracting Job Responsibilities: The Legal Counsel, **Members Only** Contracting, is tasked with providing legal advice and recommendations for initiatives and projects developed in response to clients' overall objectives and needs. The role focuses on large-scale and/or high financial level...
Title: Senior Fraud and Waste Professional Job Responsibilities: The Senior Fraud and Waste Professional is responsible for conducting investigations into allegations of fraudulent and abusive practices within the healthcare industry. This role involves dealing with moderately complex to complex issues that require...
Title: Fraud and Waste Investigator Job Responsibilities: The Fraud and Waste Investigator is a pivotal role within the company's Special Investigations Unit, focusing on combating fraud, waste, and abuse in the healthcare industry. The primary responsibilities include conducting thorough investigations into allegations...