Vacancy expired!
Transforming the future of healthcare isn’t something we take lightly. It takes teams of the best and the brightest, working together to make an impact.As one of the largest healthcare technology companies in the U.S., we are a catalyst to accelerate the journey toward improved lives and healthier communities.Here at Change Healthcare, we’re using our influence to drive positive changes across the industry, and we want motivated and passionate people like you to help us continue to bring new and innovative ideas to life. If you’re ready to embrace your passion and do what you love with a company that’s committed to supporting your future, then you belong at Change Healthcare.Pursue purpose. Champion innovation. Earn trust. Be agile. Include all. Empower Your Future. Make a Difference.Overview of PositionThe Authorization Nurse coordinates the team approach to management of patient care on an in-patient as well as outpatient basis. This position works closely with the department manager and the Medical Director to evaluate, monitor and assure the appropriateness and medical necessity of selected care for members as it relates to quality, continuity and cost effectiveness. This position will assist staff in maintaining balance between the needs of the patient, physician, IPA and contracted health plan. This position is responsible for managing utilization and, if necessary, discussing utilization of service and standards of patient management.What will be my duties and responsibilities in this job?Adheres to and supports the mission, purpose, philosophy, objectives, policies, and procedures HIPAA Compliance Plan and the Privacy Standards Confidentiality Agreement.
Demonstrates support for the Corporate Compliance Program by being knowledgeable of compliance responsibilities as expressed in the Code of Conduct; adhering to federal and state laws, rules, regulations, and corporate policies and procedures policies that affect his/her specific job functions/responsibilities; and reporting compliance issues/concerns in a timely and appropriate manner.
Research to improve the most cost effective and quality of patient care service delivery.
Initiates discharge planning and uses an interdisciplinary process in which all members of the health care team collaborate with patients and their families to anticipate needs.
Develop and implement a plan to provide service after discharge.
Facilitates cost effective and quality patient care by effective communication with physicians, providers and members.
Performs on-site or telephone reviews of patient’s charts to determine medical necessity of hospitalization.
Facilitates long-term placement of patients at skilled and custodial levels of care.
Maintains knowledge of the standards of practice and the patient care case management criteria guidelines established by the IPA.
Identifies sentinel events and communicates these and other issues to the appropriate departments.
What are the requirements needed for this position?Registered Nurse and/or Bachelor’s degree preferred.
Minimum of 3 years’ experience in a managed care setting and/or recent clinical experience.
What other skills/experience would be helpful to have?Ability to prioritize and organize work area despite multi-faceted task directions and interruptions.
Experience and understanding of the confidentiality of medical records A thorough understanding of the managed care environment from the perspective of the member, physician and hospital.
Ability to handle difficult people/situations.
Excellent interpersonal skills with the ability to interface with physicians, hospital staff, members and health plan in a tactful, informed and customer oriented manner.
Strong written and verbal communication skills.
What are the working conditions and physical requirements of this job? Remote – home office
How much should I expect to travel? No Travel Required
Physical requirements:What critical skills are needed for you to consider someone for this position?What other skills/experience would be helpful to have?How much should I expect to travel?Employees in roles that require travel will need to be able to qualify for a company credit card or be able to use their own personal credit card for travel expenses and submit for reimbursement.Join our team today where we are creating a better coordinated, increasingly collaborative, and more efficient healthcare system! Equal Opportunity/Affirmative Action Statement Change Healthcare is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, genetic information, national origin, disability, or veteran status. To read more about employment discrimination protections under federal law, read EEO is the Law at https://www.eeoc.gov/employers/eeo-law-poster and the supplemental information at https://www.dol.gov/ofccp/regs/compliance/posters/pdf/OFCCPEEOSupplementFinalJRFQA508c.pdf.If you need a reasonable accommodation to assist with your application for employment, please contact us by sending an email to applyaccommodations@changehealthcare.com with "Applicant requesting reasonable accommodation" as the subject. Resumes or CVs submitted to this email box will not be accepted.Click here https://www.dol.gov/ofccp/pdf/pay-transp%20EnglishformattedESQA508c.pdf to view our pay transparency nondiscrimination policy.Change Healthcare maintains a drug free workplace and conducts pre-employment drug-testing, where applicable, in accordance with federal, state and local laws.Change Healthcare is an equal opportunity employer. All qualified applicant will reveive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, genetic information, national origin, disability, or veteran status.
