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...
The following jobs are no longer active but were real openings previously posted by employers.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.
/ Compliance Specialist The candidate will coordinate with various internal departments and committees to develop processes and document, manage, and monitor policies and procedures to ensure operational and procedural compliance with state and federal regulations. Will work closely with legal departments and translate legal requirements/regulations and facilitate risk assessments to highlight compliance process vulnerabilities. Recommend and build new policies and p... 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Note: This job is no longer active.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
Audit and Reimbursement II The candidate performs audit work scoped by the desk reviews and will be the in-charge auditor on small and less complex audits. Assists higher level auditor on field work and appeals as assigned. Responsible for completing interim rate reviews, tentative settlements and final settlements of providers as assigned. Performs special audits of End Stage Renal Disease (ESRD) providers and provider exception requests as assigned. Updates STAR, FISS... 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Note: This job is no longer active.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
Assistant, Clerical The candidate will work directly with clients, requesting medical records, organizing files, processing mail, answering phones and general office tasks. Must have good communication skills, work well on a team and be organized.... 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
Affairs Analyst The candidate keeps up-to-date on laws/regulations that impact the business. Ensures that all areas of the organizational unit are aware of and in compliance with the various state and federal laws/regulations that apply to business operations. Develops and maintains working knowledge of those state and federal laws/regulations that govern the business. Constantly reviews information about new laws/regulations and changes in interpretation on laws/... 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
Associate Investigator The candidate will be responsible for the independent identification, investigation and development of complex cases against perpetrators of healthcare fraud in order to recover corporate and client funds paid on fraudulent claims. Will work on claim reviews for appropriate coding, data mining, entity review, law enforcement referral, and use of proprietary data and claim systems for review of facility, professional and pharmacy claims. Responsi... 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
I, II, / Senior The candidate claim reviews for appropriate coding, data mining, entity review, law enforcement referral, and use of proprietary data and claim systems for review of facility, professional and pharmacy claims. Responsible for independently identifying and developing enterprise-wide specific healthcare investigations and initiatives that may impact more than one company health plan, line of business and/or state. Interface internally with Senior l... 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
I, II, / Senior The candidate claim reviews for appropriate coding, data mining, entity review, law enforcement referral, and use of proprietary data and claim systems for review of facility, professional and pharmacy claims. Responsible for independently identifying and developing enterprise-wide specific healthcare investigations and initiatives that may impact more than one company health plan, line of business and/or state. Interface internally with Senior l... 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
I, II or Senior The candidate will be responsible for the independent identification, investigation and development of complex cases against perpetrators of healthcare fraud in order to recover corporate and client funds paid on fraudulent claims. Primary duties may include: Claim reviews for appropriate coding, data mining, entity review, law enforcement referral, and use of proprietary data and claim systems for review of facility, professional and pharmacy cl... 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
Compliance Manager The candidate will be responsible for managing regulatory compliance functions for a major business segment, including state regulatory compliance, communications compliance and policy language development. Primary duties may include: Develops, implements and maintains formal compliance structure and computer and filing systems for compliance materials. Create the structure and processes necessary to manage filings and related activities. Manage... 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
Regulatory Compliance Duties: Responsible for managing regulatory compliance functions for a major business segment, including communications compliance, policy language development, and the evaluation of the impact of state and federal legislation on communications and policy materials. Primary duties to include: Develops, implements and maintains formal compliance structure and supporting computer and filing systems for communications compliance materials. Create t... 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