RN Virtual Health Services I

Building Location:
Business Service Center

1007190 PRE-SERVICE AUTHORIZATION - EH SS

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. 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

Current nursing licensure in state(s) of employment

Possible Remote/Hybrid Option:
Remote
Shift Rotation:
Day Rotation (United States of America)
Shift Start Time:
Shift End Time:
Weekends:

Holidays:
Union:
Employee Benefits at Essentia Health:
At Essentia Health, we’re committed to supporting your well-being, growth, and work-life balance. Our comprehensive benefits include medical, dental, vision, life, and disability insurance, along with supplemental options to fit your needs. We offer a 401(k) plan with employer contributions to help you plan for the future, and we invest in your professional development through training, tuition reimbursement, and educational programs. To help you thrive both at work and at home, we provide flexible scheduling, generous time off, and wellness resources focused on your physical, mental, and emotional health. For full details, refer to your benefit summary or contact our HR Service Center at View phone number on click.appcast.io.