Legal jobs

Director, Special Investigations Unit Duties: Report directly to chief risk and compliance officer. Lead all aspects of Anti-Fraud program and ensure alignment and coordination with enterprise-wide fraud, waste and abuse efforts.... Lead team of SIU investigators to conduct comprehensive and effective fraud investigations, including both internal... and external cases of actual or potential fraud. Ensure that SIU operations... are compliant with all applicable legal and regulatory re... 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Note: This job is no longer active.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

Consultant - Appeals (Remote Worker) Responsibilities: Support clinical consulting service programs across multiple state clients including the California Department of Managed Health Care and California Department of Health Care Services. Programs cover multiple subject areas including billing disputes, fraud and abuse, pharmacy formulary... review, development of average contract rate methodology and medical consulting. Will provide careful analysis of processes, techniques 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Note: This job is no longer active.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

Analyst Duties: Will be responsible for investigating and resolving privacy issues referred from the contact center and other departments within the project. Perform privacy audits, risk assessments and related ongoing compliance monitoring activities. Prepare management reports regarding privacy investigations and progress for review by leadership. Review and track all potential or actual privacy incidents. Revise and develop, policies and procedures to maintain con... 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

Health Care Appeals Adjudicator The candidate will support clinical consulting service programs across multiple state clients including the California Department of Managed Health Care and California Department of Health Care Services. Programs cover multiple subject areas including billing disputes, fraud and abuse, pharmacy formulary... review, development of average contract rate methodology and medical consulting. Provide careful analysis of processes, techniques and proced... 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

Consultant - Appeals The candidate will support clinical consulting service programs across multiple state clients including the California Department of Managed Health Care and California Department of Health Care Services. Programs cover multiple subject areas including billing disputes, fraud and abuse, pharmacy formulary... review, development of average contract rate methodology and medical consulting. Review cases to determine and summarize facts of each case assigned 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

Health Care Attorney(Remote) The candidate will support clinical consulting service programs across multiple state clients including the California Department of Managed Health Care and California Department of Health Care Services. Programs cover multiple subject areas including billing disputes, fraud and abuse, pharmacy formulary... review, development of average contract rate methodology and medical consulting. The position is targeted to candidates in the Sacramento, Calif... 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

Legal Case Manager/Paralegal The candidate must possess the following: Ability to multi-task and prioritize; Pay close attention to detail; Build strong relationships with clients; Have excellent customer service skills; Ability to follow up quickly with attorneys/support staff regarding current and/or potential cases; Must be a team player; Availability to travel out of the area, may require overnight stay/weekends; Understand the case manager role and process; Comm... 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

President, Compliance The candidate will be responsible for the compliance program for Federal Services and for the Federal Services Compliance Committee. Ensure Federal Services is in compliance with all applicable federal program regulations, contract requirements and Centene Corporate policies. Responsible for maintenance and updates to a formal, documented Compliance Program covering all programs in Federal Services. Maintain and track laws and regulations, contract... 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

Specialist II The candidate will, with moderate direction, handle Employment Practices Liability commercial claims of moderate exposure and complexity. Will resolve claims according to Best Practices and within authority limits. May handle multi-party claims. Regularly communicates with customers and brokers. May be dedicated to handle claims for specific accounts. Document claims file by accurately capturing and updating claims data/information in compliance with bes... 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

II - Telecommute The candidate will investigate, collect, research and analyze billing data in order to detect fraudulent, abusive or wasteful activities/practices. Will use appropriate system tools, analyzes data to detect fraudulent, abusive or wasteful payments to providers and subscribers. Prepare statistical/financial analyses and reports to document findings and maintain up-to-date case files for management review. Prepare final report and notification of... 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