Managed Care Nursing Jobs
Managed Care Nurse Jobs
Registered nurses in this role are case managers in hospitals and extended care facilities. In a hospital setting, a Bachelor's degree is required; the extended care facility usually only requires experience on the floor and many times case managers are LPNs. Managed care nurses work with a patient's insurance company or Medicare and Medicaid to ensure that the patient qualifies to remain in the facility for all the days of his stay. Case managers also work to facilitate the patient's discharge in a timely manner -- making sure all core measures for reimbursement have been met. Case managers arrange for outside service providers that the patient may require upon discharge (visiting nurse, IV therapy, physical therapy, medications, and oxygen). These nurses work closely with social workers to place patients in nursing homes, rehabilitation centers and assisted living facilities. Managed care nurses must have some clinical experience, no less than two years, and the ability to work well with physicians. Nurses in this specialty must stay abreast of the latest changes in Medicare and Medicaid reimbursement policies.
Managed Care Organizations and Associations
American Association of Managed Care Nurses (AAMCN)
4435 Waterfront Drive, Suite 101
Glen Allen, VA 23060
Website:
Phone:
(804) 747-9698