Job Description
The licensed vocational nurse (LVN) Managed Care Liaison (MCL) 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 payor sources. The MCL's overall responsibility is to negotiate service authorizations and fees with the payor sources' designated case managers and to interpret/report the patient's needs and progress to that case manager.
PIH Health is a nonprofit, regional healthcare network that serves approximately 3 million residents in the Los Angeles County, Orange County and San Gabriel Valley region. The fully integrated network is comprised of PIH Health Downey Hospital, PIH Health Good Samaritan Hospital, PIH Health Whittier Hospital, 37 outpatient medical office buildings, a multispecialty medical (physician) group, home healthcare services and hospice care, as well as heart, cancer, digestive health, orthopedics, women's health, urgent care and emergency services. The organization is nationally recognized for excellence in patient care and patient experience, and the College of Healthcare Information Management Executives (CHIME) has identified PIH Health as one of the nation's top hospital systems for best practices, cutting-edge advancements, quality of care and healthcare technology. For more information, visit PIHHealth.org or follow us on Facebook, Twitter, or Instagram.
Required Skills

• 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.

Required Experience

• Current California license as a Licensed Vocational Nurse.
• Minimum of one-year experience in community health nursing, current acute care knowledge, and skills.
• Knowledge of Title 22 and Medicare Coverage Guidelines.
• Able to demonstrate a broad knowledge of third party insurance, Managed Care, Medicare, Medi-Cal, Medicare Advantage, HMO, and PPO regulations governing home health and hospice.
• Current BLS.
• Current California driver's license and valid auto insurance.