Legal jobs

Network Manager Senior/ Director Duties: Develops the HealthLink provider network in Illinois and surrounding areas through contract negotiations, relationship development, and servicing for large health systems and includes multiple provider types, ancillary, hospitals and physicians (not just one of these provider types). Primary focus of this role is contracting and negotiating contract terms. Spends a minimum of the time either in a leadership role or that of su... 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Note: This job is no longer active.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

Investigator The candidate will be responsible for investigating, collecting, researching and analyzing billing data in order to detect fraudulent, abusive or wasteful activities/practices. Primary duties may include: Using appropriate system tools, analyzes data to detect fraudulent, abusive or wasteful payments to providers and subscribers. Ensures investigations are managed and documented in an audit ready and compliant manner. Prepares statistical/financial analys... 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Note: This job is no longer active.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

Counsel / Senior Associate General Counsel / Associate General Counsel Senior The candidate will provide legal support to the Grievances and Appeals department regarding the resolution of disputes from members and providers, and work on mitigating the regulatory and litigation risks arising from those disputes. Will regularly interact with state regulators in connection with member grievances and provider disputes, including in particular in California. Provide legal a... 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

Investigator The candidate 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. May interface internally with Senior level 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

Manager The candidate will be responsible for managing foundational and strategic compliance responsibilities with consistent excellence that support the team and management. Manage/oversee projects, initiatives, regulatory audits or exams, internal audits, accreditations, on-site reviews, risk assessments; audit planning, conducting mock audits, conducting audit training, managing audit evidence preparation, assessing audit preparedness. Establish project plans,... 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

Manager - Fraud Investigations The candidate will be the lead investigator for risk adjustment investigations. Will manage foundational and strategic compliance responsibilities with consistent excellence that support the team and management. Develop and improve risk adjustment investigation process and tools. Partner with clinical, data, and medical coding partners to assess provider and associate behavior for fraud, waste and abuse. Conduct risk assessments and... 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

Manager - RN / Certified Coder The candidate will manage foundational and strategic compliance responsibilities with consistent excellence that support the team and management. Will develop and improve risk adjustment investigation process and tools. Collaborate with clinical, data, and medical coding partners to assess provider and associate behavior for fraud, waste and abuse. Conduct medical record reviews and risk assessments. Develop materials to support inve... 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

Manager - Fraud Investigations The candidate will be the lead investigator for risk adjustment investigations. Will manage foundational and strategic compliance responsibilities with consistent excellence that support the team and management. Develop and improve risk adjustment investigation process and tools. Partner with clinical, data, and medical coding partners to assess provider and associate behavior for fraud, waste and abuse. Conduct risk assessments and... 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

VP DBG General Counsel The candidate will provide leadership and strategic oversight for all aspects of the Diversified Business Group (DBG). Will provide in-depth knowledge of a legal specialty or area of law to provide advice and recommendations to executives and management on highly complex matters which have a broad organizational impact and high level of risk. Partner with clients to drive company's DBG strategic outcomes and make complex decisions. Lead legal pro... 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

Manager The candidate is responsible for directing foundational and strategic compliance responsibilities with consistent excellence that support the team and management. Responsible for managing foundational and strategic compliance responsibilities with consistent excellence that support the team and management. Conducts in-depth strategic research, provides analytical support including analysis and synthesis of business, technical, government documents with a h... 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