Title: Grievance & Appeals Nurse (RN) Job Responsibilities: - Investigate and process medical necessity appeals requests from members and providers. - Support legal, management, and executive leadership by managing State Fair Hearing and External Medical Review requests. - Act as...
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...
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: 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: 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: 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...