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Cincinnati Children's Hospital Medical Center Logo
Cincinnati Children's Hospital Medical Center

Cincinnati, Ohio

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Veterans Affairs, Veterans Health Administration

Mather AFB, California

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Veterans Affairs, Veterans Health Administration

Hampton, Virginia

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Baylor Scott & White Health

TEMPLE, Texas

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Veterans Affairs, Veterans Health Administration

Richmond, Virginia

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Penn State Health

Camp Hill, Pennsylvania

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Veterans Affairs, Veterans Health Administration

Livermore, California

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Children's Hospital of Philadelphia

Philadelphia, Pennsylvania

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Geisinger

Lewistown, Pennsylvania

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Geisinger

Danville, Pennsylvania

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Veterans Affairs, Veterans Health Administration

Martinsburg, West Virginia

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Veterans Affairs, Veterans Health Administration

Marion, Illinois

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Optum

Worcester, Massachusetts

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Springfield Clinic

Springfield, Illinois

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Harris Health System

Houston, Texas

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Baylor Scott & White Health

PLANO, Texas

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Veterans Affairs Palo Alto Health Care System

Palo Alto, California

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Veterans Affairs, Veterans Health Administration

Amarillo, Texas

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Veterans Affairs, Veterans Health Administration

San Diego, California

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Centura Health

Colorado Springs, Colorado

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Managed Care Spec
JOB SUMMARYThe Managed Care Specialist 1 is responsible for the ongoing implementation and improvement of contract enforcement processes when contract violations related to Prompt Payment have escalated to require legal intervention. This position works with various stakeholders (Managed Care, Central Business Services, Legal Counsel) to ensure a coordinated process with measurable outcomes.ESSENTIAL FUNCTIONS OF THE ROLEServes as primary contact for Central Business Services (CBS), the Transplant Business Unit, Legal and Managed Care for managed care claims management escalated for legal follow up.Assists with the development, implementation and maintenance of the Prompt Pay Database.Manages claims identification and review p


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