HCA Healthcare · 2 weeks ago
Case Management Managed Care Consultant
Nashville, TN
Full-time
Onsite
Senior Level
5+ years expHCA Healthcare is a leading organization committed to investing in its team members. They are seeking a Case Management Managed Care Consultant to apply clinical and case management expertise in legal proceedings, support claims evaluation, and provide proactive education to prevent claim issues.
BiotechnologyHealth CareHospitalMedicalPrimary and Urgent Care
Responsibilities
Conducts comprehensive clinical record reviews and detailed claims analyses
Identifies and synthesizes key medical and case management issues relevant to legal proceedings
Stays informed on healthcare regulations, legal developments, and national/community resources impacting case management
Serves as a witness in cases requiring specialized Case Management expertise
Educates and advises teams to proactively reduce risk of non-payment on claims and prevent recurrence of similar cases
Supports the corporate Case Management team with ad-hoc projects and strategic initiatives
Demonstrates strong task and priority management to meet deadlines and deliver high-quality outcomes
Contributes to the design and evolution of Case Management programs, integrating current research and evidence-based practices
Collaborates with Case Management and Legal leadership to develop and implement policies, procedures, toolkits, training, communications, and reporting frameworks
Upholds the organization’s Code of Conduct and aligns with its Mission and Values
Performs other duties assigned, supporting the broader goals of the Case Management and Legal teams
Qualification
Required
5+ years of experience in Case Management required
3+ years of experience in Clinical Nursing required
Registered Nurse – Currently licensed as a register professional nurse in the state in which he or she practices, in accordance with law and regulation. Compact RN License is a plus
Requires up to 50% travel to provide onsite testimony and legal support
Must relocate to Nashville & work in office
Preferred
Masters degree preferred
3+ years of experience in Healthcare Legal Testimony preferred
3+ years of experience in HCA Case Management highly preferred. CM knowledge and experience in multiple markets/divisions is a plus
Legal Nurse Consultant Certified (LNCC) preferred
Benefits
Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical transportation.
Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more.
Free counseling services and resources for emotional, physical and financial wellbeing
401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service)
Employee Stock Purchase Plan with 10% off HCA Healthcare stock
Family support through fertility and family building benefits with Progyny and adoption assistance.
Referral services for child, elder and pet care, home and auto repair, event planning and more
Consumer discounts through Abenity and Consumer Discounts
Retirement readiness, rollover assistance services and preferred banking partnerships
Education assistance (tuition, student loan, certification support, dependent scholarships)
Colleague recognition program
Time Away From Work Program (paid time off, paid family leave, long- and short-term disability coverage and leaves of absence)
Employee Health Assistance Fund that offers free employee-only coverage to full-time and part-time colleagues based on income.
Company
HCA Healthcare
HCA Healthcare provides medical education and healthcare services in locally managed facilities. It is a sub-organization of North Florida Endoscopy Center.
10001+ employees
Funding
Current Stage
Public CompanyTotal Funding
$8.51B2025-10-31Post Ipo Debt· $3.25B
2025-02-24Post Ipo Debt· $5.25B
2014-06-25Post Ipo Debt· $3.2M
Leadership Team
Nicholas Manning
Chief Executive Officer
Nick Lane
Regional Vice President Human Resources
Recent News
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