Registered Nurse (RN) Pre-Service Authorizations Team - Remote
Job Description:
Conducts Managed Care Programs in conjunction with third party administrators' health care agreements. Works collaboratively with and provides clinical expertise and leadership to Access Coordinators to perform all aspects of managed care, including the referral, prior authorization/precertification processes, using and revising Essentia Health's established policies and procedures for managed care activities. Performs complex care coordination and referral management. Works collaboratively with the Essentia Health customer service personnel to provide efficient service for insurance issue resolution and smooth operations. Works collaboratively with clinical areas and business services both internally and externally. Supports efforts and participates with the Supervisor of Contracting & Payor Relations and the Health Plans Medical Directors regarding health care initiatives and compliance issues for health plans.
Education Qualifications:
Job Description
No educational requirement.
Licensure/Certification Qualifications:Current nursing licensure in state(s) of employment
FTE1
Shift Rotation
Day Rotation (United States of America)
Shift Start Time
0800
Shift End Time
1630
Pay Range
$62358 - $93538 / year
The approximate base compensation range is posted, but the actual offer will reflect our total compensation and benefits package. The offer will be determined by a number of factors including the selected candidate's experience, knowledge, skills, abilities, FTE, as well as internal equity among our team.
WeekendsNo
Effective December 1, 2019: Job offers are contingent upon successful completion of a post-offer assessment, including a urine drug screen, immunization review, proof of required vaccinations, and background check. Essentia Health is committed to maintaining a work environment free from the influence of illegal drugs and alcohol.
Essentia Health EEO:
Essentia Health is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, sexual identity, national origin, disability, protected veteran status, or any other characteristic protected by law.
