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The health and safety of our patients and employees is our highest priority. We have mobilized a swift, efficient, and comprehensive response to the current situation related to COVID-19 so that our staff can stay on the front lines, giving care safely. We welcome your application and will connect with you as soon as we can, possibly virtually. Please note that many positions will not be progressing as fast as they normally would, as we prioritize our current needs. Although some positions will be on hold while we focus on providing support for our staff, trust that your application will be reviewed and considered for future openings.

Managed Care Specialist

San Diego, California
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Job ID 4387 Date posted 09/15/2020 Schedule Full-Time Shift Day Department Managed Care Operations

JOB SUMMARY:
Responsible for completion of Letter of Agreements, coordinating timely completion of contract transplant information/surveys and health delivery organization credentialing applications. Provide assistance with mapping of transplant claims, policy and procedure development, operational support for departmental projects, and development and production of key performance metrics for the Managed Care team. Coordinates communication and problem resolutions regarding process/claims issues within the department and with our affiliated entities. Utilizes effective interpersonal skills to initiate, cultivate and maintain cooperative relationships with all internal and external customers.

MINIMUM QUALIFICATIONS:
Bachelor's Degree or 4 years of relevant experience
1 year of experience
Experience in a Managed Care Operations or Managed Care Claims position

PREFERRED QUALIFICATIONS:
3 years of experience
In addition to the minimum qualifications, it is preferred if the applicant has some experience with claims, credentialing materials/applications and transplant claims/contracted provider surveys

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  • Managed Care Operations, San Diego, California, United StatesRemove