RN Pre-Service Authorizations

Company: Essentia Health
Location: Duluth
Posted on: March 12, 2025

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 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: BSN or ADN degree from an accredited school or college of nursing Be a part of a Healthcare organization that invests in you and your career. Apply now and help us continue to raise the bar in patient care! Licensure/Certification Qualifications: Current nursing licensure in state(s) of employment
Employee Benefits at Essentia Health : Health Coverage: Medical, dental, vision, life and disability insurance, plus supplemental health benefit options to ensure employees' well-being.Retirement Savings Plans: 401(k) with employer contributions to support long-term financial security.Professional Development: Opportunities for career growth through training, tuition reimbursement, and educational programs.Work-Life Balance: Flexible scheduling, time off, holidays, and personal leave to help employees manage their professional and personal lives.Employee Wellness Programs: Initiatives focused on physical, mental, and emotional health, including fitness memberships, counseling services, and wellness activities. Eligibility for Essentia Health's benefit programs vary. Please refer to the benefit summary provided to you, or contact our HR Service Center at for more information. Job Location: Business Service Center Shift Rotation: Day Rotation (United States of America) Shift Start/End: 0800 / 1630 Hours Per Pay Period: 80 Compensation Range: $69826 - $104749 / year FTE: 1 Weekends: No

Keywords: Essentia Health, Duluth , RN Pre-Service Authorizations, Healthcare , Duluth, Minnesota