Vaya Health Benefits Overview

Develops, architects, and supports custom applications using full-stack .NET technologies. Translates business requirements into reliable solutions, manages application administration, coordinates user acceptance testing, maintains relational databases, documents systems, resolves technical issues, and applies application security standards. Collaborates with business intelligence, analytics, MIS, and functional teams while managing upgrades, backups, change control, and system performance.

Provides phone-based support to network and prospective providers regarding claims, billing, authorizations, benefits, contracting, credentialing, services, and resources. Screens and routes inquiries, seeks first-call resolution, documents interactions, conducts outbound calls, and serves as a subject matter expert for provider support operations. Requires knowledge of North Carolina behavioral health and intellectual/developmental disability services, Medicaid waivers, provider policies, and applicable confidentiality regulations.

Provide community outreach, education, and training on the Transitions to Community Living (TCL) program and RSVP process. Identify and resolve service barriers, coordinate care across providers and agencies, document interventions in consumer records, support DOJ reporting, and collaborate with stakeholders to facilitate transitions and diversion efforts.