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WMCHealth

Valhalla, New York

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Durham, North Carolina

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Valhalla, New York

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Nashville, Tennessee

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Fairbanks, Alaska

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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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