Managed Care Resource
Atlanta, GA · On-site +1
The Managed Care Consultant supports the Skilled Nursing Facility leaders in managed care contracting and revenue enhancement strategies for all healthcare payers and preparation for changes in the ...
Managed Care Resource
Atlanta, GA · On-site +1
The Managed Care Consultant supports the Skilled Nursing Facility leaders in managed care contracting and revenue enhancement strategies for all healthcare payers and preparation for changes in the ...
Managed Care Resource
Whittier, CA · On-site +1
$110K - $130K/yr
The Managed Care Consultant supports the Skilled Nursing Facility leaders in managed care contracting and revenue enhancement strategies for all healthcare payers and preparation for changes in the ...
Managed Care Resource
Whittier, CA · On-site +1
$110K - $130K/yr
The Managed Care Consultant supports the Skilled Nursing Facility leaders in managed care contracting and revenue enhancement strategies for all healthcare payers and preparation for changes in the ...
The Managed Care Consultant supports the Skilled Nursing Facility leaders in managed care contracting and revenue enhancement strategies for all healthcare payers and preparation for changes in the ...
The Managed Care Consultant supports the Skilled Nursing Facility leaders in managed care contracting and revenue enhancement strategies for all healthcare payers and preparation for changes in the ...
Managed Care Resource
Nashville, TN · On-site +1
The Managed Care Consultant supports the Skilled Nursing Facility leaders in managed care contracting and revenue enhancement strategies for all healthcare payers and preparation for changes in the ...
Managed Care Resource
Nashville, TN · On-site +1
The Managed Care Consultant supports the Skilled Nursing Facility leaders in managed care contracting and revenue enhancement strategies for all healthcare payers and preparation for changes in the ...
Managed Care Resource
$110K - $130K/yr
The Managed Care Consultant supports the Skilled Nursing Facility leaders in managed care contracting and revenue enhancement strategies for all healthcare payers and preparation for changes in the ...
Managed Care Resource
$110K - $130K/yr
The Managed Care Consultant supports the Skilled Nursing Facility leaders in managed care contracting and revenue enhancement strategies for all healthcare payers and preparation for changes in the ...
Managed Care Resource
Los Angeles, CA · On-site +1
$110K - $130K/yr
The Managed Care Consultant supports the Skilled Nursing Facility leaders in managed care contracting and revenue enhancement strategies for all healthcare payers and preparation for changes in the ...
Managed Care Resource
Los Angeles, CA · On-site +1
$110K - $130K/yr
The Managed Care Consultant supports the Skilled Nursing Facility leaders in managed care contracting and revenue enhancement strategies for all healthcare payers and preparation for changes in the ...
Managed Care Resource
Pomona, CA · On-site +1
$110K - $130K/yr
The Managed Care Consultant supports the Skilled Nursing Facility leaders in managed care contracting and revenue enhancement strategies for all healthcare payers and preparation for changes in the ...
Managed Care Resource
Pomona, CA · On-site +1
$110K - $130K/yr
The Managed Care Consultant supports the Skilled Nursing Facility leaders in managed care contracting and revenue enhancement strategies for all healthcare payers and preparation for changes in the ...
The Managed Care Consultant supports the Skilled Nursing Facility leaders in managed care contracting and revenue enhancement strategies for all healthcare payers and preparation for changes in the ...
The Managed Care Consultant supports the Skilled Nursing Facility leaders in managed care contracting and revenue enhancement strategies for all healthcare payers and preparation for changes in the ...
Managed Care Resource
Orlando, FL · On-site +1
The Managed Care Consultant supports the Skilled Nursing Facility leaders in managed care contracting and revenue enhancement strategies for all healthcare payers and preparation for changes in the ...
Managed Care Resource
Orlando, FL · On-site +1
The Managed Care Consultant supports the Skilled Nursing Facility leaders in managed care contracting and revenue enhancement strategies for all healthcare payers and preparation for changes in the ...
Managed Care Resource
Jacksonville, FL · On-site
The Managed Care Consultant supports the Skilled Nursing Facility leaders in managed care contracting and revenue enhancement strategies for all healthcare payers and preparation for changes in the ...
Managed Care Resource
Jacksonville, FL · On-site
The Managed Care Consultant supports the Skilled Nursing Facility leaders in managed care contracting and revenue enhancement strategies for all healthcare payers and preparation for changes in the ...
Managed Care Resource
Nashville, TN · On-site
The Managed Care Consultant supports the Skilled Nursing Facility leaders in managed care contracting and revenue enhancement strategies for all healthcare payers and preparation for changes in the ...
Managed Care Resource
Nashville, TN · On-site
The Managed Care Consultant supports the Skilled Nursing Facility leaders in managed care contracting and revenue enhancement strategies for all healthcare payers and preparation for changes in the ...
Managed Care Resource
Jacksonville, FL · On-site +1
The Managed Care Consultant supports the Skilled Nursing Facility leaders in managed care contracting and revenue enhancement strategies for all healthcare payers and preparation for changes in the ...
Managed Care Resource
Jacksonville, FL · On-site +1
The Managed Care Consultant supports the Skilled Nursing Facility leaders in managed care contracting and revenue enhancement strategies for all healthcare payers and preparation for changes in the ...
Hybrid - MLTC RN Case Manager - Bilingual - Managed Care Plan
Bronx, NY · On-site
$105K - $115K/yr
... Managed Care Plan servicing New York. The RN Care Manager position works as a Hybrid - Remote Case Manager, working primarily from home, with 1 day of Field Case Management visits per week, in ...
Quick apply
Hybrid - MLTC RN Case Manager - Bilingual - Managed Care Plan
Bronx, NY · On-site
$105K - $115K/yr
... Managed Care Plan servicing New York. The RN Care Manager position works as a Hybrid - Remote Case Manager, working primarily from home, with 1 day of Field Case Management visits per week, in ...
Hybrid - MLTC RN Case Manager - Bilingual - Managed Care Plan
Bronx, NY · On-site
$105K - $115K/yr
... Managed Care Plan servicing New York. The RN Care Manager position works as a Hybrid - Remote Case Manager, working primarily from home, with 1 day of Field Case Management visits per week, in ...
Quick apply
Hybrid - MLTC RN Case Manager - Bilingual - Managed Care Plan
Bronx, NY · On-site
$105K - $115K/yr
... Managed Care Plan servicing New York. The RN Care Manager position works as a Hybrid - Remote Case Manager, working primarily from home, with 1 day of Field Case Management visits per week, in ...
Managed Care Manager
New York, NY · On-site
$112K - $170K/yr
As a recipient of the Magnet Award for Nursing Excellence, HSS was the first hospital in New York ... What you will be doing Managed Care Manager Reporting to the Director of Payer Relations, the ...
Managed Care Manager
New York, NY · On-site
$112K - $170K/yr
As a recipient of the Magnet Award for Nursing Excellence, HSS was the first hospital in New York ... What you will be doing Managed Care Manager Reporting to the Director of Payer Relations, the ...
... Nurse * Experience with Microsoft Word, Excel, and PowerPoint * Experience with electronic health records Preferred * Knowledge of Managed Care guidelines * Knowledge of HEDIS and STARS Measures
... Nurse * Experience with Microsoft Word, Excel, and PowerPoint * Experience with electronic health records Preferred * Knowledge of Managed Care guidelines * Knowledge of HEDIS and STARS Measures
RN- MANAGED CARE ADMINISTRATION The facility in Denver seeks 2 F/T RN Case Managers for excellent contract working in Managed Care department. Responsibilities: * Must have BSN, 3 years' experience ...
RN- MANAGED CARE ADMINISTRATION The facility in Denver seeks 2 F/T RN Case Managers for excellent contract working in Managed Care department. Responsibilities: * Must have BSN, 3 years' experience ...
Managed Care Liaison
Lakewood, NJ · On-site
Our Liaison Department assists nursing homes with various billing inquiries and other issues related to Managed Care. Applicants must have experience in either medical billing or case management ...
Quick apply
Managed Care Liaison
Lakewood, NJ · On-site
Our Liaison Department assists nursing homes with various billing inquiries and other issues related to Managed Care. Applicants must have experience in either medical billing or case management ...
Managed Care Coordinator
$38K - $48K/yr
C. is a group of Nurse Practitioners, Physician Assistants, RN Case Managers and LPN's who provide care to Elderplan members who are residents of assisted living and long term care facilities, as ...
Managed Care Coordinator
$38K - $48K/yr
C. is a group of Nurse Practitioners, Physician Assistants, RN Case Managers and LPN's who provide care to Elderplan members who are residents of assisted living and long term care facilities, as ...
Managed Care Coordinator
Manhattan, NY · On-site
$38K - $48K/yr
C. is a group of Nurse Practitioners, Physician Assistants, RN Case Managers and LPN's who provide care to Elderplan members who are residents of assisted living and long term care facilities, as ...
Managed Care Coordinator
Manhattan, NY · On-site
$38K - $48K/yr
C. is a group of Nurse Practitioners, Physician Assistants, RN Case Managers and LPN's who provide care to Elderplan members who are residents of assisted living and long term care facilities, as ...
Managed Care Nurse information
See salary details
$21.15 - $25.57
2% of jobs
$25.57 - $29.98
6% of jobs
$29.98 - $34.40
13% of jobs
$35.32 is the 25th percentile. Wages below this are outliers.
$34.40 - $38.81
19% of jobs
The median wage is $41.28 / hr.
$38.81 - $43.23
18% of jobs
$43.23 - $47.64
15% of jobs
$48.74 is the 75th percentile. Wages above this are outliers.
$47.64 - $52.05
9% of jobs
$52.05 - $56.47
6% of jobs
$56.47 - $60.88
4% of jobs
$60.88 - $65.30
4% of jobs
$65.30 - $69.71
3% of jobs
$21
$44
$69
How much do managed care nurse jobs pay per hour?
As of Aug 24, 2026, the average hourly pay for managed care nurse in the United States is $44.35, according to ZipRecruiter salary data. Most workers in this role earn between $35.58 and $50.96 per hour, depending on experience, location, and employer.
What is a managed care nurse?
A Managed Care Nurse is a registered nurse who works within the managed care system to coordinate patient care, ensure cost-effective treatment, and facilitate communication between patients, healthcare providers, and insurance companies. Their role often includes case management, reviewing treatment plans, and advocating for patients to receive appropriate services. Managed Care Nurses help optimize healthcare delivery by balancing quality of care with cost efficiency, often working for insurance companies, hospitals, or healthcare networks.
What are some common challenges managed care nurses face when coordinating care between providers and insurance companies?
Managed Care Nurses often encounter challenges such as navigating complex insurance policies, ensuring patients receive necessary treatments within coverage guidelines, and effectively communicating between healthcare providers and insurers. Balancing cost containment with optimal patient care is a key part of the role, which can be demanding when coverage restrictions conflict with clinical recommendations. Strong organizational and advocacy skills help Managed Care Nurses overcome these hurdles and ensure patients receive appropriate, timely care.
What are the key skills and qualifications needed to thrive as a managed care nurse, and why are they important?
To thrive as a Managed Care Nurse, you need a solid background in nursing practice, care coordination, and case management, often supported by an RN license and experience in managed care settings. Familiarity with utilization review software, electronic health records, and knowledge of insurance processes or certifications like CCM (Certified Case Manager) are typical requirements. Strong communication, critical thinking, and negotiation skills help Managed Care Nurses advocate for patient needs while balancing cost-effective care. These competencies are crucial for ensuring patients receive appropriate, timely care and for navigating the complex healthcare and insurance landscape.
What is the difference between Managed Care Nurse vs Case Manager Nurse?
| Aspect | Managed Care Nurse | Case Manager Nurse |
|---|---|---|
| Credentials | RN license, possibly certifications in case management or managed care | RN license, certifications in case management (e.g., CCM) |
| Work Environment | Insurance companies, managed care organizations, healthcare plans | Hospitals, clinics, insurance companies, community health |
| Employer & Industry Usage | Primarily in managed care settings, insurance providers | Healthcare facilities, insurance, community health programs |
Both Managed Care Nurses and Case Manager Nurses are registered nurses with similar certifications, often working in healthcare or insurance settings. Managed Care Nurses focus on coordinating care within managed care organizations, while Case Manager Nurses handle patient care planning across various healthcare environments. Their roles overlap in patient advocacy and care coordination, but their work settings and specific responsibilities differ slightly.
More about Managed Care Nurse jobs
What cities are hiring for Managed Care Nurse jobs?
Cities with the most Managed Care Nurse job openings:
What states have the most Managed Care Nurse jobs?
States with the most job openings for Managed Care Nurse jobs include:
Full-time
Medical, Dental, Vision, Life, Retirement, PTO
Re-posted 7 days ago
Ensign Group rating
6.5
Based on 168 frontline employees who took The Breakroom Quiz
607th of 893 rated healthcare providers
Job description
Managed Care Resource - Southeast Region
Position Type: Full-time, exempt employee.
Compensation Range: Depending on Experience.
Location: Candidate must reside in the Atlanta, Georgia area.
About the Company:
Ensign Services, Inc. ("ESI") is a subsidiary of The Ensign Group, Inc. whose affiliated entities are considered national leaders in the fast-growing post-acute care industry. ESI provides service and support to over 378 facilities in the long-term care continuum that employ over 55,000 employees.
ESI is known as the "Service Center" and provides the facilities and leaders it serves with "back-office" support in areas such as accounting, construction, compliance, human resources, information technology, learning and development, legal and risk management and recruiting. This structure allows the onsite leaders and caregivers to focus on day-to-day care and operational issues in their individual operations. What sets ESI apart from other companies is the quality of our most valuable resource - our people.
We take our core values of Celebration, Accountability, Passion for Learning, Love One Another, Intelligent Risk Taking, Customer Second, and Ownership ("CAPLICO") seriously. We want an individual in this role who will demonstrate these values through actions and words.
About the Opportunity:
The Managed Care Consultant supports the Skilled Nursing Facility leaders in managed care contracting and revenue enhancement strategies for all healthcare payers and preparation for changes in the healthcare industry. The Consultant will provide guidance regarding development of managed care relationships and rate negotiation, ensuring timeliness and rate appropriateness. Additionally, the Consultant will negotiate contracts for new locations, assist with ensuring that contracts are updated for new services and help with contract cancellations, denials and appeals.
Job Duties and Responsibilities include, but are not limited to:
Preferred Qualifications:
Additional Information:
What We Offer:
We are committed to providing a competitive benefits and compensation package which includes medical/dental/vision coverage, company-provided life insurance, 401(k) with company match, and sick/vacation plans. We also believe in supporting our employee's professional growth and development through our Learning Management System as well as training sessions and seminars. Take a look at these benefits (and more!) at www.ensignbenefits.com.
Ensign Services, Inc. is an equal opportunity employer. If you need assistance or accommodation during the application process, please contact us at 888-659-3616.
Job ID: 1230
Position Type: Full-time, exempt employee.
Compensation Range: Depending on Experience.
Location: Candidate must reside in the Atlanta, Georgia area.
About the Company:
Ensign Services, Inc. ("ESI") is a subsidiary of The Ensign Group, Inc. whose affiliated entities are considered national leaders in the fast-growing post-acute care industry. ESI provides service and support to over 378 facilities in the long-term care continuum that employ over 55,000 employees.
ESI is known as the "Service Center" and provides the facilities and leaders it serves with "back-office" support in areas such as accounting, construction, compliance, human resources, information technology, learning and development, legal and risk management and recruiting. This structure allows the onsite leaders and caregivers to focus on day-to-day care and operational issues in their individual operations. What sets ESI apart from other companies is the quality of our most valuable resource - our people.
We take our core values of Celebration, Accountability, Passion for Learning, Love One Another, Intelligent Risk Taking, Customer Second, and Ownership ("CAPLICO") seriously. We want an individual in this role who will demonstrate these values through actions and words.
About the Opportunity:
The Managed Care Consultant supports the Skilled Nursing Facility leaders in managed care contracting and revenue enhancement strategies for all healthcare payers and preparation for changes in the healthcare industry. The Consultant will provide guidance regarding development of managed care relationships and rate negotiation, ensuring timeliness and rate appropriateness. Additionally, the Consultant will negotiate contracts for new locations, assist with ensuring that contracts are updated for new services and help with contract cancellations, denials and appeals.
Job Duties and Responsibilities include, but are not limited to:
- Establish, implement and evaluate the strategic plan(s) that will ensure each local operation the ability to optimize financial performance through rates and increased census.
- Engage in complex levels of contract development and negotiation, including risk agreements using utilization, claims and market data with health plans and direct service agreements with physicians, physician organizations and hospitals and ancillary providers.
- Identify, develop and maintain an effective relationship with contracted health plans and managed care regulatory agencies.
- Manage complex and high-profile health plan negotiations. Actively draft and negotiate contracts in the health care operations and health care plan functional areas.
- Assist in analysis and coordination of amendments, reimbursement, and language changes.
- Assess resource utilization, cost management and negotiate effectively.
- Monitor industry changes, trends and events to proactively identify opportunities to increase market penetration and performance improvement.
- Understands the competitive pricing levels in the local market and improves the company's cost position through unit costs strategies.
- Strategizes for facility census growth and retention.
- Teach, Train and Instruct facility level personnel on how to operationalize the contract.
- Interact with facility personnel on utilization, clinical results and managed care census.
Preferred Qualifications:
- A bachelor's degree in business administration, management or health care administration, highly desired.
- At least 2 years of experience with Managed Care contracting, highly desired.
- Must reside in Georgia, preferably in the Atlanta area.
- Willing to travel up to 80% of the time (as deemed appropriate).
- Knowledge of managed care contracting language, requirements, and methods to support the development and maintenance of contract compliance, contract language review and contract analysis.
- Must be knowledgeable about the managed care environment, including capitation, PPO, HMO, IPA, ACO and POS.
- Knowledge of CPT-4, HCPCS, Revenue and ICD coding.
- Expert in Skilled Nursing Managed care plans.
- Experience in successful operationalizing managed care contracts in the skilled nursing environment.
- Knowledge of contracts and contractual interpretations for payment and benefit issues.
- Working knowledge of medical terminology, claims payment, contract negotiations, and problem resolution; ability to work collaboratively in a team setting.
- Communicate effectively at all organizational levels and in situations requiring instructing, persuading, negotiating, consulting, and advising.
- Ability to deal with responsibility with confidential matters. Maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA).
- Strong analytical mind, with problem solving skills, an aptitude for accuracy, and attention to detail.
- Must be able to prioritize, plan, and handle multiple tasks/demands simultaneously.
- Excellent verbal and written communication skills, as well as excellent critical thinking skills.
- Computer savvy (Contract Logix, MS Word, MS Outlook & Excel).
- Ability to be flexible, be readily adaptable, and work in a rapidly and constantly changing environment.
- Present in facilities on a weekly basis, (currently as deemed appropriate).
Additional Information:
- Pre-employment criminal background screening required.
What We Offer:
We are committed to providing a competitive benefits and compensation package which includes medical/dental/vision coverage, company-provided life insurance, 401(k) with company match, and sick/vacation plans. We also believe in supporting our employee's professional growth and development through our Learning Management System as well as training sessions and seminars. Take a look at these benefits (and more!) at www.ensignbenefits.com.
Ensign Services, Inc. is an equal opportunity employer. If you need assistance or accommodation during the application process, please contact us at 888-659-3616.
Job ID: 1230
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