Title: Nurse Appeals (Grievance & Appeals) Job Responsibilities: The Nurse Appeals is tasked with investigating and processing medical necessity appeals requests from both members and providers. This role supports legal, management, and executive leadership by managing State Fair Hearing and External Medical...
Title: Investigator Senior - Pharmacy Job Responsibilities: The Investigator Senior - Pharmacy is responsible for independently identifying, investigating, and developing complex healthcare cases against perpetrators of healthcare fraud to recover corporate and client funds paid on fraudulent claims. Key responsibilities include: - Conducting...
Title: Managing Counsel – Data Center and Networking (Power and Energy Focus) Job Responsibilities: The Managing Counsel for Data Center and Networking with a focus on Power and Energy at **Members Only** is a key position within the legal department. The role involves...
support regarding the company's . employee benefit plans and programs. The primary responsibilities include: - Advising Benefits and other internal teams on the design, administration, and compliance of the company's . employee benefit plans, including the 401(k) plan, health & we...
Title: Claims Adjuster - Complex Casualty Litigation Job Responsibilities: - Manage complex commercial claim investigations, interpret coverage, and investigate liability. - Handle claims involving multiple vehicles, competing claims, and significant injuries. - Direct counsel through the litigation process and engage experts from various disciplines...
Join **Members Only**'s Health Care Practice Group as... and Associates for their Health Care Practice Group in... multiple Ohio locations. This is a great opportunity to be a part of a thriving and growing practice, with a focus on...
Title: Associate Professor / Professor, Vice Chair of Research, Department of Emergency Medicine Job Overview: The Department of Emergency Medicine at a reputed firm is seeking an accomplished and visionary leader for the position of Vice Chair of Research. This role will...
Job Title: Health Care Litigation Associates Job Responsibilities: -... for trial with a focus on health care litigation. - Handle health... care regulatory matters and... ensure compliance with HIPAA. - Conduct state and federal agency audits and investigations. - Manage payor disputes and participate i...
Title: Nurse Appeals (Grievance & Appeals) Job Responsibilities: - Investigate and process medical necessity appeal requests from members and providers. - Support legal, management, and executive leadership by managing State Fair Hearing and External Medical Review requests. - Act as a resource for both...
Title: Legal Editor, Practice Area Content Job Responsibilities: Author & Contributor Relationships - Recruit, onboard, and support external authors while setting clear expectations for scope, style, and delivery. - Maintain productive long-term relationships with authors, intervening early to resolve performance issues or revise author...
Title: Senior Intellectual Property Reporter Job Responsibilities: - Writing in-depth commentary pieces on relevant topics related to intellectual property litigation and regulation, with a significant focus on the federal courts and the United States Patent and Trademark Office. - Quickly turning around clear,...
Title: Senior Legal Counsel Job Responsibilities: The Senior Legal Counsel will join the Workplace Investing (WI) legal team at the company and play a crucial role in advising on various aspects of defined contribution plan recordkeeping, administration, trust, and institutional business. The...