Title: Senior Corporate Counsel - Benefits Job Responsibilities: - Provide legal guidance and strategic support for the company's . employee benefit plans and programs, ensuring compliance with applicable laws and regulations. - Advise Benefits and other internal teams on the design, administration, and...
Title: Nurse Appeals (Grievance & Appeals) Job Responsibilities: The Nurse Appeals role involves investigating and processing medical necessity appeal requests from members and providers. Key responsibilities include: - Supporting legal, management, and executive leadership by managing State Fair Hearing and External Medical Review...
Contract Manager The candidate will manage the full life cycle of Pharmacy Benefit Management (PBM) contracts from RFP through client contract execution. Oversee the contract approval process, ensuring compliance, version control, and support the negotiation and execution of standard and...
Title: Experienced Paralegal – Litigation / Healthcare Job Responsibilities: - Obtain, review, and analyze documents, including medical records, financial records, tax and employment records, or any other relevant information. - Create medical record chronologies to assist in case preparation. - Prepare for trial by...
Title: Nurse Appeals (Grievance & Appeals) Job Responsibilities: The Nurse Appeals role involves a range of responsibilities focused on managing and processing medical necessity appeals from members and providers. Key duties include: - Supporting legal, management, and executive leadership by managing State Fair...
medical summaries of pertinent medical records. - Create medical audits of treatment expenses for use in the evaluation of damages. - Perform the medical record retrieval process to obtain supplemental medical records in compliance with HIPAA requirements. - Conduct medical research... on s...
ACA, ERISA, the Code, HIPAA, and COBRA. - Develop and... present materials on various health and welfare compliance-related issues to internal sales teams and external clients. - Establish effective working relationships with internal partners, clients, and carriers. - Function as part of a...
depositions and handle complex discovery and Electronic Stored Information (ESI). - Prepare cases for trial, ensuring comprehensive readiness for court proceedings. - Manage health care regulatory matters, including compliance with HIPAA regulations. - Handle state and... federal agency audits and investigations efficiently. - Ad...
Overview: A distinguished law firm is currently seeking a midlevel Associate Attorney to join its Data Privacy and Cybersecurity practice group. This position is ideal for legal professionals with a minimum of two years of experience in breach response and...