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Pediatrix Medical Group Logo
Pediatrix Medical Group

Orem, UT, USA

AdventHealth Logo
AdventHealth

Castle Rock, Colorado

Veterans Affairs, Veterans Health Administration Logo
Veterans Affairs, Veterans Health Administration

Bedford, Massachusetts, Massachusetts

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Veterans Affairs, Veterans Health Administration

Columbia, South Carolina, South Carolina

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Veterans Affairs, Veterans Health Administration

Togus, Maine, Maine

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Veterans Affairs, Veterans Health Administration

White City, Oregon, Oregon

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Veterans Affairs, Veterans Health Administration

Sioux Falls, South Dakota, South Dakota

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Veterans Affairs, Veterans Health Administration

Brockton, Massachusetts, Massachusetts

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Veterans Affairs, Veterans Health Administration

Richmond, Virginia, Virginia

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Veterans Affairs, Veterans Health Administration

Albuquerque, New Mexico, New Mexico

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Veterans Affairs, Veterans Health Administration

Togus, Maine, Maine

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Veterans Affairs, Veterans Health Administration

Martinsburg, West Virginia, West Virginia

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Veterans Affairs, Veterans Health Administration

Cape Coral, Florida, Florida

MCR Health, Inc.

Bradenton, Florida

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Veterans Affairs, Veterans Health Administration

Manchester, New Hampshire, New Hampshire

Northwell Health Logo
Northwell Health

New York, New York

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Veterans Affairs, Veterans Health Administration

Togus, Maine, Maine

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ScionHealth

Louisville, Kentucky

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Veterans Affairs, Veterans Health Administration

Asheville, North Carolina, North Carolina

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Veterans Affairs, Veterans Health Administration

Chesapeake County, Virginia, Virginia

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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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