Title: Associate General Counsel Job Responsibilities: - Provide counsel and advice on legal matters involving **Members Only**. - Interpret governmental regulations and statutes. - Offer legal oversight to the development, implementation, and enforcement of **Members Only** policies and procedures. - Participate in providing legal advice...
The following jobs are no longer active but were real openings previously posted by employers.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.
Nurse Consultant - Nurse Reviewer The candidate will provide consultative services. Will work with liability claims and staff legal files. Evaluate medical treatment to ensure quality, effective and cost-effective care. Supply Technical resource to claims. Review medical records to analyze treatments verses standards of care/ medical necessity. Confirm acceptable standards of medical care by utilizing clinical expertise, professional judgment, supported by established... 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Note: This job is no longer active.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
Contracting Field Vice President - Central, South and West Texas The candidate will be responsible for developing and driving innovative network design and risk contracting strategies to ensure company builds a quality provider network to meet the health care needs of members across all products – Commercial, Medicare, Medicaid, Dual Eligible and the Exchange. Serve as the primary liaison with the Plan's contracted vendors in the field, and responsible for managing... 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Note: This job is no longer active.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
Contracting Field Vice President Duties: Develop comprehensive knowledge of the Health and Well-being organization strategy, capabilities, best practices and tools and the current state (deployment) of the Integrated Care strategy within the Senior Products (Medicare) segment. Identify and contract with primary care physicians, specialty physicians and ancillary service providers. Ensure adequate coverage of primary care, specialty and ancillary services for company... 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
Professional Case Review Nurse The candidate will be responsible for: working with liability claims and staff legal files; evaluating medical treatment to ensure quality, effective and cost-effective care; supplying technical resource to claims; reviewing medical records to analyze treatments verses standards of care/ medical necessity; confirming acceptable standards of medical care by utilizing clinical expertise, professional judgment, supported by established cri... 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
Nurse Consultant (Virtual) Duties: Working with Liability claims and Staff Legal files. Evaluating medical treatment to ensure quality, effective and cost-effective care. Supply Technical Knowledge resource to claims. Review medical records to analyze treatments verses standards of care/ medical necessity. Confirm acceptable standards of medical care by utilizing clinical expertise, professional judgment, supported by established criteria documented in accepted peer... 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
Investigator The candidate will work on the medical review component of fraud investigations and provide clinical expertise. Will work closely with other members of the RAIU to develop cases and provide support on active cases to include medical record reviews and other investigational steps as needed. Assist with case development by providing clinical expertise when performing medical record reviews. Identify fraud schemes and trends within the assigned line of bus... 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
Lead - Insurance and Healthcare The candidate will manage the utilization review and third-party administrator licensure activities for specific states. Will monitor state and federal laws that may affect business. Evaluate, interpret, and summarize state regulatory guidelines and changes to guidelines. Work in conjunction with the Regulatory Manager and work with legal SME s ., data privacy, health regulatory for interpretation of applicable laws. Track applic... 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 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
President, Government Medicare Compliance Officer The candidate will report to the corporate Chief Compliance Officer. Will be responsible for managing, directing, overseeing and coordinating company's efforts to ensure compliance with laws, regulations and policies that govern its very substantial Medicare business. Should have a Bachelor's degree and equivalent experience. Master's or professional . degree is preferred. Must have 10+ years of substantial prior comp... 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