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 role is centered around the investigation and processing of medical necessity appeals requests from members and providers. The primary duties include: - Supporting legal, management,...
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: Pharmacy Investigator Lead Job Responsibilities: - Provide leadership and guidance to the Special Investigations Unit Pharmacy team to investigate, collect, research, and analyze billing data to detect fraudulent, abusive, or wasteful activities/practices. - Assist the team manager with the administration and operational...
Title: Nurse Appeals – Litigation & Legal Support Job Responsibilities: - Supports legal, management, and executive leadership by managing State Fair Hearing and External Medical Review requests. - Acts as a resource for both clinical and non-clinical teams by managing and conducting thorough...
Title: Associate General Counsel - Litigation Job Responsibilities: The Associate General Counsel is tasked with providing legal advice and strategic 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...
Title: Associate General Counsel Job Responsibilities: The Associate General Counsel is an integral part of the Office of the General Counsel, working under the guidance of the Associate Vice President and Deputy General Counsel for the company. This role involves managing a...
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....