Office. - Investigate and prosecute crimes with federal, state, and local law enforcement. - Prosecute criminal identity theft and beneficiary-side fraud cases relating to Centers for Medicare and Medicaid Services (CMS)... programs. - Lead cases from investigation through charging, pretrial litigation, trial, sent...
within its Centers for Medicare and Medicaid Division (CMSD),... Program Enforcement, Fraud Prosecutor Program. These attorneys will take on the role of fraud prosecutors and will be detailed as Special Assistant United States Attorneys (SAUSAs) to various . Attorney’s Offices....
Title: Litigation Paralegal Job Responsibilities: - Research background of claims to gather necessary information for litigation. - Monitor the status of claims and update the litigation database accordingly. - Gather information needed to defend or pursue litigation matters. - Respond to subpoenas, garnishments, subrogation, property...
Title: Nurse Appeals – Litigation & Legal Support Job Responsibilities: The Nurse Appeals – Litigation & Legal Support is tasked with the investigation and processing of medical necessity appeals requests from members and providers. Key responsibilities include: - Supporting legal, management, and executive...
Title: Legal Counsel, **Members Only** Contracting Job Responsibilities: - Negotiate and manage client contracts with various clients including health plan clients, state agencies, and employer groups. - Collaborate with business partners and legal colleagues to improve contract management workflows and policies. - Become the resident...
issues in a complex healthcare environment. - Offer healthcare regulatory advice concerning Anti-Kickback Statute (AKS), Stark Law, False Claims Act (FCA), Centers for Medicare & Medicaid Services (CMS),... and state rules and regulations related to arrangements with physician practices. - Collaborate w...
Title: Lead Counsel, Practice Management Job Responsibilities: - Serve as a principal legal advisor for CORE Ventures and The US Oncology Network, providing sophisticated, solutions-oriented guidance on a broad range of legal, regulatory, and business matters affecting oncology practice management. - Lead and...
Title: Sr. Director, Compliance & Ethics - PRISM & Multi-Specialty MSOs Job Responsibilities: - Assist the Vice President in developing strategic direction and delivering compliance program support for **Members Only**’s Oncology & Multispecialty (“O&M”) businesses, including PRISM Vision Group and other management services...
health care law. The role involves defending medical professionals and handling various legal matters related to health physicians, dentists, and nurses before review defense of Stark and antikickback defense of Medicaid and Medicare fraud physician e......