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?

Competitive Pay
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