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:
Current nursing licensure in state(s) of employmentBLS certification within one monthACLS certification within one year
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:
Our Benefits are exceptional and Include:
Tuition Reimbursement/Assistance Program
Paid Personal Leave
401k (with Essentia Health annual match)
Life and Disability Insurance options
Adoption Assistance
Employee wellness program
Medical & Dental insurance options
Like nowhere else:
https://vimeo.com/284233541
To learn more about Duluth, MN and our surrounds areas https://www.essentiahealth.org/about/communities/duluth .
https://www.essentiahealth.org/about/communities/
FTE
1
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.
Weekends
No
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.
Equal Employment Opportunity (EEO) at Essentia
It is our policy to afford EEO to all individuals, regardless of race, religion, color, sex, pregnancy, gender identity, national origin, age, disability, family medical history, genetic information, sexual orientation, marital status, military service or veteran status, culture, socio-economic status, status with regard to public assistance, and other factors not related to qualifications, including employees or applicants who inquire about, discuss, or disclose their compensation or the compensation of other employees or applicants, or membership or activity in a local human rights commission, or any other category as defined by law.
