Henry Ford Health System
RN Referral Management Coordinator (Virtual) - Prior Authorizations - 40 Hours - Day Shift - HAP Health Alliance Plan
This job is now closed
Job Description
- Req#: 104871
Employer Industry: Healthcare Services
Why consider this job opportunity:
- Full-time, benefit-eligible position
- Opportunity for career advancement and growth within the organization
- Work remotely with a flexible schedule
- Collaborative team environment with experienced professionals
- Engage in meaningful work that impacts patient care and quality management
What to Expect (Job Responsibilities):
- Process referral requests by verifying network assignment and clinical appropriateness
- Coordinate peer-to-peer conversations with the Medical Director and providers
- Manage denial processing and communicate with providers regarding request outcomes
- Report potential quality of care issues to the Quality Management Department
- Track and report physician non-compliance with Utilization Management Policies and Procedures
What is Required (Qualifications):
- Nursing Diploma required
- Minimum of two (2) years of recent clinical management experience in an inpatient or ambulatory setting, or two (2) years of experience in Utilization or Quality Management required
- Registered Nurse (RN) with current Michigan licensure required
How to Stand Out (Preferred Qualifications):
- Bachelor's Degree in Health Care or a related field preferred
#HealthcareServices #RemoteWork #Nursing #CareerOpportunity #QualityManagement
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We are not the EOR (Employer of Record) for this position. Our role in this specific opportunity is to connect outstanding candidates with a top-tier employer.About the company
The Henry Ford Health System is a comprehensive, integrated, non-profit health care organization in Metro Detroit.
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