What are the responsibilities and job description for the Managed Care Nursing Specialist position at Brickyard Healthcare?
We are looking for a dedicated and compassionate Managed Care Nursing Specialist (RN or LPN) to join our team. In this role, you will provide centralized or field-based case management for managed care and commercial insurance payers, as well as for residents.
Why Join Our Team?
Competitive pay with various incentives.
Comprehensive health benefits packages.
Opportunities for career advancement.
Education reimbursement program up to $7,500 annually.
Flexible scheduling options.
Benefits & Conditions :
No waiting period for enrollment.
Three health plan options available.
Delta Dental coverage.
Vision coverage through VSP.
Free basic life insurance.
Disability, critical illness, accident, and legal coverage.
401(k) retirement plan.
Employee assistance program.
Key Responsibilities :
Act as a liaison between the Living Center / Agency and the insurance plan to ensure appropriate payment for services rendered.
Communicate care plans to insurance case managers, emphasizing strong discharge planning.
Explain insurance benefits to staff and families at all levels.
Understand contract provisions and associated exclusions.
Conduct cost analyses and negotiate service rates.
Provide consultation on appeals, retro authorizations, and collections matters.
Qualifications :
Must be licensed as a Registered Nurse (RN) or Licensed Practical Nurse (LPN).
Minimum of two (2) years of clinical experience is preferred.
Preferred experience of two (2) to three (3) years in case management.
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