Managed Care Specialist (RN or LPN)

Brickyard Healthcare; Brownsburg (IN); On-site; USD 60,000 - 90,000; Full time

Job summary

An established industry player is seeking a Managed Care Specialist to provide centralized case management for insurance payers. This role requires a compassionate RN or LPN who excels in communication and negotiation, ensuring that residents receive the proper level of care and payment. With excellent pay, multiple incentives, and a comprehensive benefits package, this position offers career advancement opportunities and flexible scheduling. Join a dedicated team that values your expertise and commitment to quality care, making a meaningful impact in the lives of residents and their families.

Benefits

Excellent pay with multiple incentives

Excellent health benefits packages

Career advancement opportunities

Education reimbursement program up to $7,500 per year

Flexible scheduling available

No waiting period for enrollment

Three health plan options

Delta Dental

VSP Vision

Free Basic Life Insurance

Qualifications

• Must be licensed as RN or LPN with 2-3 years of case management experience.
• Strong communication and negotiation skills are essential.

Responsibilities

• Act as liaison between Living Center and insurance for payment levels.
• Communicate care plans to insurance case managers effectively.
• Provide cost analysis and negotiate service rates.

Skills

Case Management

Communication Skills

Negotiation Skills

Clinical Experience

Education

Licensed Registered Nurse (RN)

Licensed Practical Nurse (LPN)

Job description

We rely on and trust our Managed Care Specialist (RN or LPN) to provide centralized or field-based case management for managed care and commercial insurance payers and residents. The right candidate for this role is a dedicated and compassionate team player.

Why Work For Us?

1. Excellent pay with multiple incentives:
2. Excellent health benefits packages
3. Career advancement opportunities
4. Education reimbursement program of up to $7,500 per year
5. Flexible scheduling available

Benefits & Conditions:

1. No waiting period for enrollment
2. Three health plan options
3. Delta Dental
4. VSP Vision
5. Free Basic Life Insurance
6. Disability, Critical Illness, Accident & Legal Coverage
7. 401(k) Retirement Plan
8. Employee Assistance Program

Responsibilities:

1. Communicates, negotiates, and acts as liaison between Living Center/Agency and the insurance plan to ensure proper level of payment is assigned for services provided.
2. Communicates care plan to insurance case managers with emphasis on strong discharge planning.
3. Communicates insurance benefits to all levels of associates and families.
4. Understands provisions of contracts and associated exclusions.
5. Provides cost analysis and negotiation of services and/or rates.
6. Consults on appeals, retro authorizations, and collections issues.

Qualifications:

1. Licensed as a Registered Nurse (RN) or Licensed Practical Nurse (LPN).
2. Minimum two (2) years clinical experience preferred.
3. Minimum two (2) to three (3) years case management experience preferred.
4. Must be capable of maintaining regular attendance.