- Travelers Insurance Company (Hartford, CT)
- …surety bonds to or on behalf of businesses of all sizes. The BSI Claim Counsel team conducts thorough investigation, analysis, evaluation, and disposition of ... claims and claim litigation to achieve superior...provides coverage for Community Associations, Healthcare Institutions and Providers, Managed Care Organizations, Life and Health Underwriters… more
- The County of Los Angeles (Los Angeles, CA)
- …staff issues; health facility licensing, healthcare organization certification and accreditation; managed care and the Knox-Keene Act; and/or medical malpractice ... SENIOR DEPUTY COUNTY COUNSEL - HEALTHCARE LAW Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4318147) Apply ...experience in the practice of healthcare law pertaining to managed care and the Knox-Keene Act. If… more
- CGI Technologies and Solutions, Inc. (Atlanta, GA)
- **Senior Employment Counsel ** **Category:** Legal Affairs **Main location:** United States, Virginia, Fairfax **Alternate Location(s):** United States, Georgia, ... from strategic IT and business consulting to systems integration, managed IT and business process services and intellectual property...CGI is offering a full-time opportunity for Senior Employment Counsel to join our US legal team. The position… more
- Prime Therapeutics (Frankfort, KY)
- …Anti-Kickback Statute, and False Claims Act, with a focus on PBM and managed care operations + Experience engaging with regulatory bodies (eg, CMS, OIG, ... every decision we make. **Job Posting Title** Deputy General Counsel , Litigation - REMOTE **Job Description** The Deputy General...of experience as an attorney and 5 years representing managed care companies, health care … more
- Novant Health (Charlotte, NC)
- …ventures, strategic partnerships and foundational knowledge of healthcare operations. + Managed care , value based arrangements and physician network experience ... Job Summary This Assistant General Counsel /Director role provides legal advice and counsel...network operations, including physician contracting, employment law, and patient care related legal matters. The ideal candidate has a… more
- Mass Markets (KY)
- …RESPONSIBILITIES Key Responsibilities: + Provide legal support as needed by the General Counsel + Draft, review, and revise contracts and advise on contracts and ... and other business documents. + Give accurate and timely counsel to the different internal business units and executives...the basis of age, ancestry, color, family or medical care leave, gender identity or expression, genetic information, marital… more
- New York State Civil Service (Queens, NY)
- NY HELP Yes Agency Workers' Compensation Board Title Compensation Claims Referee (NY HELPS), WCB Item #3845 Occupational Category Legal Salary Grade 28 Bargaining ... No Telecommuting allowed? Yes County Queens Street Address Office of General Counsel , Adjudication Services 168-46 91st Avenue 3rd Floor City Queens (Jamiaca) State… more
- Library of Congress (Washington, DC)
- …authors of literary, dramatic, musical, artistic, and other works. The Copyright Claims Officer has responsibilities and delegated authority for the oversight and ... and reference services to the public. Through the Copyright Claims Board, it also administers an efficient and user-friendly... Officer reports to the US Copyright Office General Counsel . Has overall responsibility, as well as delegated authority,… more
- Molina Healthcare (Cleveland, OH)
- … research and/or issue resolution or analysis of reimbursement methodologies within the managed care health care industry **PREFERRED EDUCATION:** Bachelor's ... claims and inquiries. Handles escalated inquiries, complex provider claims payments, records, and provides counsel to...complex provider claims payments, records, and provides counsel to providers. Helps to mentor and coach Provider… more
- The Institute for Family Health (New Paltz, NY)
- …SKILLS: + Thorough understanding of FQHC, Article 28, Article 31, dental CMS, managed care , sliding fee, and commercial payer billing guidelines and regulations. ... and timely management of the receivables + Prepare evaluations, counsel staff on performance, and execute disciplinary actions up...be responsible for Claim Printing/Reviewing of printed claim forms for accuracy to ensure claims … more
- Huron Consulting Group (Van Buren, AR)
- …pressure to improve clinical outcomes and reduce the cost of providing patient care . Investing in new partnerships, clinical services and technology is not enough to ... Management Manager provides management of standardized vendor processes to support Huron Managed Services clients and teams. This role is responsible for oversight… more
- UPMC (Pittsburgh, PA)
- …of the clinical and management staff. Establish a working relationship with staff of managed care organization and office site staff to facilitate integration of ... Risk Management, the role involves systematically managing potential and actual claims . Analyzing clinical data is crucial for identifying liability areas, with… more
- Molina Healthcare (Nampa, ID)
- …investigative and law enforcement procedures with emphasis on fraud investigations. + Knowledge of Managed Care and the Medicaid and Medicare programs as well as ... Understanding of claim billing codes, medical terminology, anatomy, and health care delivery systems. + Understanding of datamining and use of data analytics to… more
- New York State Civil Service (Albany, NY)
- …Open FACTS cases and maintain/update throughout the DAR/FAR process.* Vet providers and Managed Care plans.* Supporting the Contractor in the preparation and ... reports in OMIG's data management tracking system.* Analyzing and vetting submitted claim data by the Contractor for accuracy and to prevent intra-agency duplication… more
- Marriott (Bethesda, MD)
- …and effective safety and security policies and procedures, ensuring duty of care and achieving desired results. This role manages the operational safety and ... on efficiency of delivery, consistency of policy, procedure and duty of care , and effectiveness through desired results. Contributes thought leadership to the… more
- Prime Healthcare (Ontario, CA)
- …part of a team, and strong interpersonal skills + Experience in managed care contracting, provider re-imbursement, fee-scheduling, prior experience in Healthplan ... risk mitigation strategies. . May be involved in contract claims and disputes. Compliance and Legal Issues:. Ensures compliance...regulations, and industry standards. . May work with legal counsel on complex legal issues related to contracts. .… more
- Comerica (Dallas, TX)
- …to support their business initiatives and enhance employee engagement. Provides counsel to business partner leaders to proactively anticipate and address complex ... calls, requests from problem resolution and employee grievance complaints and agency claims . Ensures compliance with federal, state and local employment laws and… more