Managed Care Resource
Nashville, TN · On-site +1
Managed Care Resource - Southeast Region Position Type: Full-time, exempt employee. Compensation Range: Depending on Experience. Location: Candidate must reside in the Nashville, Tennessee area.
60 Care Resource Full Time Jobs Hiring Near You
Managed Care Resource
Nashville, TN · On-site +1
Managed Care Resource - Southeast Region Position Type: Full-time, exempt employee. Compensation Range: Depending on Experience. Location: Candidate must reside in the Nashville, Tennessee area.
Managed Care Resource
Whittier, CA · On-site +1
$110K - $130K/yr
Managed Care Resource - Los Angeles, CA Position Type: Full Time, exempt employee. Salary: $110,000 - $130,000 annually, DOE; may be eligible for bonus. Location: Candidate must reside in the Los ...
Managed Care Resource
Whittier, CA · On-site +1
$110K - $130K/yr
Managed Care Resource - Los Angeles, CA Position Type: Full Time, exempt employee. Salary: $110,000 - $130,000 annually, DOE; may be eligible for bonus. Location: Candidate must reside in the Los ...
Managed Care Resource
Whittier, CA · On-site
$110K - $130K/yr
Managed Care Resource - Los Angeles, CA Position Type: Full Time, exempt employee. Salary: $110,000 - $130,000 annually, DOE; may be eligible for bonus. Location: Candidate must reside in the Los ...
Managed Care Resource
Whittier, CA · On-site
$110K - $130K/yr
Managed Care Resource - Los Angeles, CA Position Type: Full Time, exempt employee. Salary: $110,000 - $130,000 annually, DOE; may be eligible for bonus. Location: Candidate must reside in the Los ...
Managed Care Resource
Los Angeles, CA · On-site
$110K - $130K/yr
Managed Care Resource - Los Angeles, CA Position Type: Full Time, exempt employee. Salary: $110,000 - $130,000 annually, DOE; may be eligible for bonus. Location: Candidate must reside in the Los ...
Managed Care Resource
Los Angeles, CA · On-site
$110K - $130K/yr
Managed Care Resource - Los Angeles, CA Position Type: Full Time, exempt employee. Salary: $110,000 - $130,000 annually, DOE; may be eligible for bonus. Location: Candidate must reside in the Los ...
Managed Care Resource
Orlando, FL · On-site
Managed Care Resource - Southeast Region Position Type: Full-time, exempt employee. Compensation Range: Depending on Experience. Location: Candidate must reside in the Orlando, Florida area. About ...
Managed Care Resource
Orlando, FL · On-site
Managed Care Resource - Southeast Region Position Type: Full-time, exempt employee. Compensation Range: Depending on Experience. Location: Candidate must reside in the Orlando, Florida area. About ...
Managed Care Resource
Long Beach, CA · On-site
$110K - $130K/yr
Managed Care Resource - Los Angeles, CA Position Type: Full Time, exempt employee. Salary: $110,000 - $130,000 annually, DOE; may be eligible for bonus. Location: Candidate must reside in the Los ...
Managed Care Resource
Long Beach, CA · On-site
$110K - $130K/yr
Managed Care Resource - Los Angeles, CA Position Type: Full Time, exempt employee. Salary: $110,000 - $130,000 annually, DOE; may be eligible for bonus. Location: Candidate must reside in the Los ...
Managed Care Resource
Pomona, CA · On-site
$110K - $130K/yr
Managed Care Resource - Los Angeles, CA Position Type: Full Time, exempt employee. Salary: $110,000 - $130,000 annually, DOE; may be eligible for bonus. Location: Candidate must reside in the Los ...
Managed Care Resource
Pomona, CA · On-site
$110K - $130K/yr
Managed Care Resource - Los Angeles, CA Position Type: Full Time, exempt employee. Salary: $110,000 - $130,000 annually, DOE; may be eligible for bonus. Location: Candidate must reside in the Los ...
Managed Care Resource
Atlanta, GA · On-site +1
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 ...
Managed Care Resource
Atlanta, GA · On-site +1
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 ...
Managed Care Resource
Orlando, FL · On-site +1
Managed Care Resource - Southeast Region Position Type: Full-time, exempt employee. Compensation Range: Depending on Experience. Location: Candidate must reside in the Orlando, Florida area. About ...
Managed Care Resource
Orlando, FL · On-site +1
Managed Care Resource - Southeast Region Position Type: Full-time, exempt employee. Compensation Range: Depending on Experience. Location: Candidate must reside in the Orlando, Florida area. About ...
Managed Care Resource
Jacksonville, FL · On-site +1
Managed Care Resource - Southeast Region Position Type: Full-time, exempt employee. Compensation Range: Depending on Experience. Location: Candidate must reside in the Jacksonville, Florida area.
Managed Care Resource
Jacksonville, FL · On-site +1
Managed Care Resource - Southeast Region Position Type: Full-time, exempt employee. Compensation Range: Depending on Experience. Location: Candidate must reside in the Jacksonville, Florida area.
Managed Care Resource
Charlotte, NC · On-site +1
Managed Care Resource - Southeast Region Position Type: Full-time, exempt employee. Compensation Range: Depending on Experience. Location: Candidate must reside in the Charlotte, NC area. About the ...
Managed Care Resource
Charlotte, NC · On-site +1
Managed Care Resource - Southeast Region Position Type: Full-time, exempt employee. Compensation Range: Depending on Experience. Location: Candidate must reside in the Charlotte, NC area. About the ...
Managed Care Resource
Jacksonville, FL · On-site
Managed Care Resource - Southeast Region Position Type: Full-time, exempt employee. Compensation Range: Depending on Experience. Location: Candidate must reside in the Jacksonville, Florida area.
Managed Care Resource
Jacksonville, FL · On-site
Managed Care Resource - Southeast Region Position Type: Full-time, exempt employee. Compensation Range: Depending on Experience. Location: Candidate must reside in the Jacksonville, Florida area.
Managed Care Resource
Pomona, CA · On-site +1
$110K - $130K/yr
Managed Care Resource - Los Angeles, CA Position Type: Full Time, exempt employee. Salary: $110,000 - $130,000 annually, DOE; may be eligible for bonus. Location: Candidate must reside in the Los ...
Managed Care Resource
Pomona, CA · On-site +1
$110K - $130K/yr
Managed Care Resource - Los Angeles, CA Position Type: Full Time, exempt employee. Salary: $110,000 - $130,000 annually, DOE; may be eligible for bonus. Location: Candidate must reside in the Los ...
Managed Care Resource - Southeast Region Position Type: Full-time, exempt employee. Compensation Range: Depending on Experience. Location: Candidate must reside in the Nashville, Tennessee area.
Managed Care Resource - Southeast Region Position Type: Full-time, exempt employee. Compensation Range: Depending on Experience. Location: Candidate must reside in the Nashville, Tennessee area.
Managed Care Resource
Charlotte, NC · On-site
Managed Care Resource - Southeast Region Position Type: Full-time, exempt employee. Compensation Range: Depending on Experience. Location: Candidate must reside in the Charlotte, NC area. About the ...
Managed Care Resource
Charlotte, NC · On-site
Managed Care Resource - Southeast Region Position Type: Full-time, exempt employee. Compensation Range: Depending on Experience. Location: Candidate must reside in the Charlotte, NC area. About the ...
Managed Care Resource
Atlanta, GA · On-site
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 ...
Managed Care Resource
Atlanta, GA · On-site
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 ...
Managed Care Resource
Los Angeles, CA · On-site +1
$110K - $130K/yr
Managed Care Resource - Los Angeles, CA Position Type: Full Time, exempt employee. Salary: $110,000 - $130,000 annually, DOE; may be eligible for bonus. Location: Candidate must reside in the Los ...
Managed Care Resource
Los Angeles, CA · On-site +1
$110K - $130K/yr
Managed Care Resource - Los Angeles, CA Position Type: Full Time, exempt employee. Salary: $110,000 - $130,000 annually, DOE; may be eligible for bonus. Location: Candidate must reside in the Los ...
Managed Care Resource
Long Beach, CA · On-site +1
$110K - $130K/yr
Managed Care Resource - Los Angeles, CA Position Type: Full Time, exempt employee. Salary: $110,000 - $130,000 annually, DOE; may be eligible for bonus. Location: Candidate must reside in the Los ...
Managed Care Resource
Long Beach, CA · On-site +1
$110K - $130K/yr
Managed Care Resource - Los Angeles, CA Position Type: Full Time, exempt employee. Salary: $110,000 - $130,000 annually, DOE; may be eligible for bonus. Location: Candidate must reside in the Los ...
Critical Care Resource Nurse
Franklin, TN · On-site
Employee Health Assistance Fund that offers free employee-only coverage to full-time and part-time ... an) Critical Care Resource Nurse. We want your knowledge and expertise! Job Summary and ...
Critical Care Resource Nurse
Franklin, TN · On-site
Employee Health Assistance Fund that offers free employee-only coverage to full-time and part-time ... an) Critical Care Resource Nurse. We want your knowledge and expertise! Job Summary and ...
Critical Care Resource Nurse
Lebanon, TN · On-site
Employee Health Assistance Fund that offers free employee-only coverage to full-time and part-time ... an) Critical Care Resource Nurse. We want your knowledge and expertise! Job Summary and ...
Critical Care Resource Nurse
Lebanon, TN · On-site
Employee Health Assistance Fund that offers free employee-only coverage to full-time and part-time ... an) Critical Care Resource Nurse. We want your knowledge and expertise! Job Summary and ...
Care Resource Jobs Information
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Full-time
Medical, Dental, Vision, Life, Retirement, PTO
Re-posted 11 days ago
Ensign Group rating
6.5
Based on 168 frontline employees who took The Breakroom Quiz
605th of 889 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 Nashville, Tennessee 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 1231
Position Type: Full-time, exempt employee.
Compensation Range: Depending on Experience.
Location: Candidate must reside in the Nashville, Tennessee 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 Tennessee, preferably in the Nashville 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 1231
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