Managed Care Specialist - American Senior Communities LLC

Managed Care Specialist

Become a Managed Care Nurse at American Senior Communities in Indianapolis, IN, and start making a difference in the lives of seniors today! Ideal candidate will be a Physical Therapy Assistant. Familiarity with insurance coverage is a must.

What does a Managed Care Nurse do each day at ASC?

• Making a difference in the lives of the patients we serve by providing them care and compassion.
• Acting as a positive teammate to fellow employees by helping onboard new teammates.

• Screens for the appropriateness of managed care referrals with insurance as primary payor by obtaining prior authorization when appropriate.  Coordinates initial assessment; then collaborates with concurrent review team member for continued authorization throughout skilled stay. Serves as a liaison between patients, family, physician, discharge hospital planner, insurance companies and ASC interdisciplinary team.  Maximizes managed care census and reimbursement potential.

• Assists with admissions process.
• Assesses prospective patients to evaluate care needs and determine suitability for admission to ASC facility.
• Calculates daily rate/level of care, service needs and contracts with payor source for program services.
• Acts as liaison between ASC facility and insurance company.

What’s in it for you? Benefits and perks include:

• Medical/Dental/Vision insurance available - Plans starting as low as $20 a week
• 401(k)
• Paid time off and paid holidays
• Generous friend referral program
• Tuition assistance and up to $500 for certifications
• Volunteer community involvement opportunities

Requirements:

• Demonstrates C.A.R.E. values to our residents, family members, customers and staff.
• Understanding of both Long-Term Care and Acute Care diagnosis, patient care plans and managed care practices. 

We are Equal Opportunity-Affirmative Action Employer – Minority / Female / Disability / Veteran and other protected categories. 

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. 41 CFR 60-1.35(c) Clinical Services