Teams at Vaya Health

Manages the full lifecycle of provider and vendor contracts, including drafting, negotiation, execution tracking, data integrity, reporting, storage, and archiving. Maintains the contract lifecycle management platform, supports procurement activities, trains staff, communicates with stakeholders, and supervises a Contracts Specialist. Collaborates with Legal, Finance, Information Services, and Provider Network Operations on contract administration, vendor management, and process improvement.

Builds and maintains partnerships among local agencies, healthcare stakeholders, advocacy groups, and government officials across an assigned North Carolina region. Represents Vaya Health on community boards, addresses system barriers, resolves stakeholder concerns, educates agencies about resources, and recommends solutions to leadership. Provides regional input on healthcare initiatives, supports staff and community capacity-building, and promotes collaborative approaches to mental health, developmental disability, and substance abuse service needs.

Reviews inpatient hospital claims before and after payment, validating ICD-10 coding, MS-DRG assignments, medical necessity, reimbursement accuracy, and regulatory compliance. Conducts audits, identifies fraud and utilization patterns, verifies claim adjustments, prepares decision notices and statistical data, supports appeals and litigation testimony, and develops fraud-prevention edits. Provides technical assistance and provider education. Requires extensive inpatient coding, clinical documentation, claims payment, and reimbursement expertise.