Title: Grievance & Appeals Nurse (RN) Job Responsibilities: - The Nurse Appeals is responsible for investigating and processing medical necessity appeals requests from members and providers. - Supports legal, management, and executive leadership by managing State Fair Hearing and External Medical Review requests. -...
Title: Legal Counsel, **Members Only** Contracting Job Responsibilities: - Provide legal advice and recommendations for initiatives and projects aligned with clients' overall objectives and needs. - Focus on large-scale and/or high financial level projects with broad department and/or organizational impact and moderate level of...
Title Legal Counsel, Carelon Contracting Job Responsibilities The Legal Counsel for Carelon Contracting is tasked with providing legal advice and recommendations for initiatives and projects that align with clients' overall objectives and needs. This role focuses on large-scale and/or high...
sizes. - Prepare and argue motions in court. - Take depositions and manage complex discovery processes, including Electronic Stored Information (ESI). - Prepare cases for trial, ensuring all legal and procedural requirements are met. - Engage with health care regulatory matters, including HIPAA, stat...
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 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...