RN/LVN Managed Care Liaison - Home Health - PIH Health - La Mirada, CA
*Must be an RN or LVN
The Managed Care Liaison possesses those abilities that combine clinical expertise in community health with an understanding of the financial aspects of home care and aptitude for negotiation with third party payer sources. The Managed Care Liaison's overall responsibility is to negotiate service authorizations and fees with the payer sources designated case manager and to interpret/report the patient's needs and progress to that case manager. Required skills include but are not limited to:
Understanding of the cost of providing home health service/hospice and the scope of the department's services.
Familiarity with prevailing prices/practices of the area.
Strong verbal skills.
Basic computer knowledge and abilities and calculator abilities.
Ability to organize and prioritize.
Broad knowledge of Medicare and Medi-Cal coverage.
Understanding of clinical range of home care.
Ability to negotiate. Understands and is focused on good customer service.
Current California license as a Registered Nurse or Licensed Vocational Nurse. Renewal every 2 years in good standing.
Minimum of one-year experience in community health nursing, current acute care knowledge and skills.
Knowledge of Title 22 and HIM-11.
Able to demonstrate broad knowledge of third party insurance, Managed Care, Medicare, Medi-Cal regulations governing home health and hospice.
Current CPR card.
Current California driver's license and valid auto insurance.
PIH Health is a nonprofit, regional healthcare network with two hospitals, numerous outpatient medical offices, a multispecialty medical (physician) group, home healthcare services and hospice care, as well as heart, cancer and emergency services. Our leadership is dedicated to putting patients first-a cornerstone of our mission, vision and values-as we deliver top-quality healthcare.
Please Click APPLY to submit your resume for consideration
Associated topics: lead, licensed practical nurse, licensed vocational nurse, lpn, lvn, med, med surg, nurse i, nurse iii, nurse iv
* The salary listed in the header is an estimate based on salary data for similar jobs in the same area. Salary or compensation data found in the job description is accurate.