Registered Nurse - Managed Care (80 hrs per pay period)
Company: Essentia Health
Location: Esko
Posted on: February 20, 2021
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Job Description:
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 Essenita 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:None
Licensure/Certification Qualifications:Current nursing licensure in
state(s) of employment
Keywords: Essentia Health, Duluth , Registered Nurse - Managed Care (80 hrs per pay period), Healthcare , Esko, Minnesota
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