Centralized Authorization Manager (Nurse Manager - Pre-Authorization)

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Position Highlights

Floyd Valley Healthcare in Le Mars, IA has a full-time position (40 hours per week) in our Centralized Prior Authorization department.
We are looking for an AMAZING Centralized Prior Authorization RN Manager with a "Get It Done" attitude! The ability to work with a TEAM in a collaborative and communicative environment is a MUST!
Centralized Prior Authorization Department Manager Responsibilities:

• Promotes the mission, vision and values of Floyd Valley Healthcare
• Directs and coordinates the centralized prior authorization process for the hospital, clinic, and outpatient clinical service departments.
• Interviewing, hiring, training and ongoing development of department staff.
• Assist with the review and establishment of operating policies and procedures for the department.
• Determines eligibility for all applicable payors by obtaining prior authorizations from insurers for medical tests, procedures, surgeries and any other prior authorizations required by the patient’s insurance carrier or Local Coverage Determination (LCD) if needed.
• Appropriately documents prior authorization and communicates information to performing facility, physician, clinic staff and patient and/or patient’s family as necessary.
• Demonstrates technological knowledge and skills sufficient to integrate the use of health care technology and/or information management systems as it pertains to prior authorizations.
• Appropriately documents prior authorization and communicates information to performing facility physician, clinic staff and patient and/or patient’s family as necessary.
• Utilization of electronic medical record and efficiently process required prior authorizations and communication within organization.
• Coordination with utilization review department with evaluation and processing of level of care authorizations.

Centralized Prior Authorization Department Manager Requirements:

• Associates of Nursing, Bachelor of Nursing is preferred. 2 years of healthcare experience.
• Licensed as a registered nurse in Iowa and/or meets the requirements of multi-state licensure required.
• Knowledge in ICD-10 and CPT coding is preferred.
• General computer knowledge is required.
• Previous supervision and coding experience preferred.
• Mandatory Reporter training certificate a plus; certification is required as an employee.

We are proud to offer:

• IPERS Retirement
• Medical, dental, and vision insurance
• Short-term and long-term disability insurance
• Life Insurance
• Fitness center
• Wellness program
• Paid time off
• Excellent training for new RNs and RNs returning to the workplace
• Salary based on experience
• Education opportunities for advanced certification

About Floyd Valley Healthcare:
Floyd Valley Healthcare is a 25-bed critical access hospital and is located in Le Mars, Iowa home of "The Ice Cream Capital of the World!" Floyd Valley Healthcare has had a rich history of serving the healthcare needs of people in Le Mars, Iowa and the surrounding communities. Today Floyd Valley includes the hospital, family medicine clinics in Le Mars, Marcus and Remsen, public health and Park Place Estates Assisted Living. We serve people in their homes through home health and home medical services. Floyd Valley Healthcare is licensed by the State of Iowa, affiliated with the Avera System of Sioux Falls, South Dakota and is a member of the Iowa and American Hospital Associations.

Background check is required.

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