Managed Care Specialist

1 week ago


Lakeland, Florida, United States Summit Full time
Job Summary

Summit is seeking a highly skilled Managed Care Specialist to join our team. As a key member of our staff, you will play a critical role in ensuring that our clients receive the highest quality medical care while minimizing costs.

Key Responsibilities
  • Monitor and facilitate each claimant's medical treatment to ensure appropriate, effective, and cost-efficient care.
  • Coordinate with vendors of rehabilitative services to ensure that services are consistent with the diagnosis and the goal of returning the claimant to employability and/or normal activities.
  • Assign cases to vendors for utilization review and provide professional advice and expertise to Claims staff in developing and providing medical and cost control procedures.
  • Lead the work of others, mentor, prioritize, delegate, and review assignments.
  • Perform other duties as assigned.
Requirements
  • Bachelor's Degree or equivalent; R.N. (Registered Nurse) or L.P.N. (Licensed Practical Nurse) preferred.
  • Field of Study: Business, Biology, Nursing, or a related discipline.
  • Generally, 6 to 10 years of related experience, including Case Management experience.
About Summit

Summit is a leading provider of workers' compensation programs and services to thousands of employers throughout the Southeast. We are committed to providing an atmosphere of constant growth and development for our employees and strive to build relationships and link people to various career paths.

We offer competitive healthcare, retirement, and paid time off benefits for full-time and part-time benefit eligible employees. If you are ready for an exciting and challenging career opportunity, apply today



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