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Samford University McWhorter School of Pharmacy

Birmingham, Alabama

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AdventHealth

Denver, Colorado

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Northeast Georgia Health System

Gainesville, Georgia

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Optum

Mebane, North Carolina

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BJC HealthCare

Saint Louis, Missouri

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Saint Louis, Missouri

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AdventHealth

Manchester, Kentucky

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Saint Louis, Missouri

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Managed Care Specialist
SUMMARY: SUMMARY: Under the direction of the Managed Care Coordinator, the Managed Care Specialist is responsible for helping ensure the financial health of North Kansas City Hospital NKCH and Meritas Health through support of enterprise managed care activities. Position will require an understanding of healthcare reimbursement for hospitals and medical groups, contract negotiation concepts, and functionality of payor websites and other technology within managed care workflows. Participates in denials management and reimbursement issue reviews. Organizes meetings with internal stakeholders and payor representatives, and collaborates with designated managed care vendors (mailers, underpayments, etc). Works closely with revenue cycle, accounting, decision support, and credentialing teams at


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