Business Service Center
1007190 PRE-SERVICE AUTHORIZATION - EH SSConducts 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.
BSN or ADN degree from an accredited school or college of nursing
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Current nursing licensure in state(s) of employment
0
Possible Remote/Hybrid Option:
Remote
Day Rotation (United States of America)
Varies
Varies
Yes
Yes
No
Compensation Range:
$33.94 - $50.91Employee 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. Please note that benefit eligibility may vary. For full details, refer to your benefit summary or contact our HR Service Center at (218) 576-0000.
Essentia Health is an integrated health system serving patients in Minnesota, Wisconsin, and North Dakota.
Headquartered in Duluth, Minnesota, Essentia Health combines the strengths and talents of more than 15,000 employees, including more than 2,200 physicians and advanced practitioners, who serve our patients and communities through the mission of being called to make a healthy difference in people’s lives.
Essentia Health, which includes many Catholic facilities, is guided by the values of Quality, Hospitality, Respect, Joy, Justice, Stewardship, and Teamwork. The organization lives out its mission by having a patient-centered focus at 14 hospitals, 78 clinics, six long-term care facilities, six assisted living and independent living facilities, six ambulance services, 24 retail pharmacies, and one research institute.
