Managed Care Specialist (RN or LPN)

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

Job summary

An established industry player is seeking a compassionate Managed Care Specialist to join their dedicated team. This role involves providing centralized or field-based case management for managed care and commercial insurance payers, ensuring residents receive the best care possible. With a focus on communication and negotiation, you will act as a liaison between various stakeholders, ensuring proper payment levels for services. This position offers excellent pay, health benefits, and opportunities for career advancement, making it an exciting opportunity for those looking to make a meaningful impact in healthcare.

Benefits

Excellent health benefits packages

Career advancement opportunities

Education reimbursement program up to $7,500

Flexible scheduling

401(k) Retirement Plan

Employee Assistance Program

Free Basic Life Insurance

Disability Coverage

Critical Illness Coverage

Accident & Legal Coverage

Qualifications

• Must be licensed as an RN or LPN with 2+ years of clinical experience.
• Experience in case management is preferred.

Responsibilities

• Act as liaison between Living Center/Agency and insurance plans.
• Communicate care plans and insurance benefits effectively.

Skills

Case Management

Communication

Negotiation

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?

• Excellent pay with multiple incentives:

• Excellent health benefits packages
• Career advancement opportunities
• Education reimbursement program of up to $7,500 per year
• Flexible scheduling available

Benefits & Conditions:

• No waiting period for enrollment
• Three health plan options
• Delta Dental
• VSP Vision
• Free Basic Life Insurance
• Disability, Critical Illness, Accident & Legal Coverage
• 401(k) Retirement Plan
• Employee Assistance Program

Responsibilities:

• 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
• Communicates care plan to insurance case managers with emphasis on strong discharge planning
• Communicates insurance benefits to all levels of associates and families
• Understands provisions of contracts and associated exclusions
• Provides cost analysis and negotiation of services and/or rates
• Consults on appeals, retro authorizations and collections issues

Qualifications:

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