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: Sr Investigator Job Responsibilities: The Sr Investigator is tasked with the independent identification, investigation, and development of complex cases against individuals or entities perpetrating healthcare fraud. The primary aim is to recover corporate and client funds that have been paid on...
Title: Nurse Appeals (Grievance & Appeals) Job Responsibilities: The Nurse Appeals role involves several critical responsibilities aimed at ensuring that medical necessity appeals are investigated and processed effectively. The key duties include: - Supporting legal, management, and executive leadership by managing State Fair...
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...
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...
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: Senior Associate Counsel Job Responsibilities: - Provide comprehensive legal and strategic guidance on the procurement, deployment, and governance of information technology systems (ISD) and artificial intelligence within a hospital setting. - Advise hospital leadership and procurement teams on the legal implications of...
Title: Assistant General Counsel - Commercial Transactions Job Responsibilities: The Assistant General Counsel - Commercial Transactions is a leadership position responsible for providing exceptional legal advice to one of the company's growing sectors, particularly in the pharmaceutical distribution, manufacturing, precision medicine, and...
General Counsel - Commercial Transactions Job Title Assistant General Counsel - Commercial Transactions Job Responsibilities The Assistant General Counsel for Commercial Transactions is tasked with providing exceptional legal advice to one of the company's expanding sectors, particularly in pharmaceutical distribution, manufacturing, precision...
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...
and Electronic Stored Information (ESI). - Prepare cases 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...
Prepare and argue motions in court. - Take and manage depositions. - Handle complex discovery and Electronic Stored Information (ESI). - Prepare cases for trial. - Engage in significant client contact to manage cases effectively. - Work on health care regulatory matters, including HIPAA comp...
Conduct depositions and manage complex discovery processes, including electronic stored information (ESI). - Prepare cases for trial, ensuring all necessary legal strategies and documentation are in place. - Handle health care regulatory matters, including compliance with HIPAA regulations. - Manage state and... fe...
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...
Title: Senior Risk Management Professional Job Responsibilities: The Senior Risk Management Professional is responsible for identifying and analyzing potential sources of loss to minimize risk within the organization. The role involves developing and implementing controls and cost-effective approaches to minimize risk specifically...
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: Senior Corporate Counsel - Benefits Job Responsibilities: The Senior Corporate Counsel - Benefits at the company will play a crucial role in providing legal guidance and strategic support regarding the company's . employee benefit plans and programs. The primary responsibilities include: -...
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: Senior Corporate Counsel - Benefits Job Responsibilities: The Senior Corporate Counsel - Benefits is tasked with providing legal guidance and strategic support for the company’s . employee benefit plans and programs. Key responsibilities include: - Advising Benefits and other internal teams on...
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 internal teams on the design, administration, and compliance of employee...
Title: Senior Corporate Counsel - Benefits Job Responsibilities: The Senior Corporate Counsel - Benefits at the company is tasked with providing expert legal guidance and strategic support concerning the company's . employee benefit plans and programs. Key responsibilities include: - Advising Benefits and...
Title: Senior Risk Management Professional Job Responsibilities: The Senior Risk Management Professional is responsible for identifying and analyzing potential sources of loss to minimize risk. The role involves developing and implementing controls and cost-effective approaches to minimize risk within the Payment Integrity...
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: Assistant General Counsel - Legal Services Job Responsibilities: The Assistant General Counsel - Legal Services provides legal advice and services through the office of General Counsel at the organization for the benefit of the organization and its subsidiaries and related companies....
Join **Members Only**'s Health Care Practice Group as a Partner or Associate H2: Immediate Opportunities in Multiple Ohio Locations **Members Only**, a national law firm with over 750 attorneys, is seeking experienced Partners and Associates for their...
Title: Counsel, Healthcare Transactions & Regulatory Data Job Responsibilities: - Advise on legal and regulatory issues related to corporate transactions such as acquisitions, dispositions, operator transitions, and facility closures, with a specific focus on healthcare considerations. - Lead or support the preparation and...
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...
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...
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...
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...
Title: Asst/Assoc/Full Professor, College of Medicine, Primary Care Physician, Midtown Job Responsibilities: - Diagnose diseases or study medical conditions using a variety of techniques such as gross pathology, histology, cytology, cytopathology, clinical chemistry, immunology, flow cytometry, and molecular biology. - Write detailed reports...
Title: Senior Health & Benefits Consulting Attorney Job Responsibilities: The Senior Health & Benefits Consulting Attorney will become part of a highly skilled team of lawyers and technical experts. The role focuses on analyzing health and welfare benefit plan legislation, regulations, subregulatory...
Title: Associate General Counsel Department: Health System Shared Services Office of Legal Affairs Job Responsibilities: The Associate General Counsel will be responsible for providing legal advice and services to the Wexner Medical Center on a broad spectrum of complex...
law firm in Columbus, OH, is seeking an experienced Associate Attorney capable of independently managing a diverse caseload. Ideally, the ideal candidate will bring substantial experience and a portable book of business to contribute to our firm's growth and ...