Managed Care SpecialistSan Diego, California
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.
Bachelor's Degree or 4 years of relevant experience
1 year of experience
Experience in a Managed Care Operations or Managed Care Claims position
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