Managed Care Specialist (RN or LPN)

Brickyard Healthcare; Fortville (IN); On-site; USD 50,000 - 80,000; Full time

Job summary

Join a compassionate team as a Managed Care Specialist where you will play a vital role in case management for insurance payers. This position offers the opportunity to make a significant impact on residents' lives by ensuring they receive the proper level of care and payment for services. With excellent pay, a robust benefits package, and opportunities for career advancement, this role is perfect for dedicated professionals looking to grow in a supportive environment. Enjoy flexible scheduling and a culture that values your contributions while providing essential services to the community.

Benefits

Excellent pay with multiple incentives

Health benefits packages

Career advancement opportunities

Education reimbursement program up to $7,500 per year

Flexible scheduling

401(k) Retirement Plan

Employee Assistance Program

No waiting period for enrollment

Free Basic Life Insurance

Disability, Critical Illness, Accident & Legal Coverage

Qualifications

• Licensed RN or LPN with 2-3 years of case management experience preferred.
• Strong communication and negotiation skills are essential.

Responsibilities

• Act as liaison between Living Center and insurance plan for payment.
• Negotiate and communicate care plans to insurance case managers.

Skills

Case Management

Communication Skills

Negotiation Skills

Clinical Experience

Education

Registered Nurse (RN) License

Licensed Practical Nurse (LPN) License

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