Remote Prior Authorization Rn Jobs in Akron, OH (NOW HIRING)

Stella Health Navigation aims to provide the guidance and care of a nurse to the plan members who need it the most. We simplify the healthcare journey, enhance partner solutions, and build trust-based relationships, supported by advanced analytics and integration with high-value partners.

We are seeking a compassionate and knowledgeable Stella Health Navigator to join our team. The ideal candidate will play a crucial role in assisting our members with their health needs, understanding their health benefits, and connecting them to partner solutions. This position involves educating members on their health conditions, scheduling doctor appointments, and providing guidance on navigating the healthcare system.

We offer a supportive work environment, opportunities for professional development, and a chance to make a meaningful impact in the lives of our members.

• Engage with members to understand their health needs and provide personalized support.
• Educate members on their health benefits and how to maximize them.
• Connect members with partner solutions and resources to address their health concerns.
• Schedule and coordinate doctor appointments and follow-up care.
• Support members by connecting them with clinical education and other resources.
• Serve as a liaison between members and healthcare providers to ensure seamless communication.
• Assist members in navigating the healthcare system and overcoming barriers to care.
• Maintain accurate and confidential member records and documentation.
• Continuous documentation and evaluation of operational processes for improvement.

Required:

• Degree from applicable program of training and a minimum of 3 years clinical experience in an acute care setting required.
• Active Registered Nursing license or equivalent within the state of practice or states in which Case Management is performed.

Preferred:

• Bachelor's degree preferred.
• Certification in related field preferred.
• Experience in care navigation, case management, or a related field is preferred.
• Strong understanding of health benefits and insurance plans.
• Excellent communication and interpersonal skills.
• Experience in scheduling and coordinating healthcare services.
• Compassionate and patient-centered approach to care.
• Ability to communicate effectively in English and Spanish preferred.

Behaviors:

• Demonstrates adequate knowledge of managed care with emphasis on use of criteria, guidelines and national standards of practice.
• Demonstrates good written and oral communications, organizational and leadership skills.
• Ability to work collaboratively in a team environment.
• Ability to educate and empower members regarding their health and wellness.
• Skilled in Microsoft 365 suite, electronic charting systems, and remote collaboration tools.
• Demonstrates good time management skills.
• Comfortable adjusting to evolving workflows and team needs.
• Takes initiative in problem-solving and process improvement.
• Current nursing license(s) to be maintained and willing to pursue additional licensure as business needs arise.

#LI-REMOTE #LI-HL1 #GBNursing

At Gallagher, we believe supporting our colleagues goes far beyond the role itself. For more information, visit our Benefits page.

• Competitive compensation
• Comprehensive benefits programs designed to support your well-being 
• Career development opportunities and ongoing learning 
• A collaborative, people-first culture with accessible leadership 
• The opportunity to do meaningful work with global reach and local impact 

At Gallagher, we are dedicated to building an inclusive and authentic workplace. If your past experience doesn’t align perfectly, we encourage you to join our Talent Community to stay connected to additional career opportunities. At times, we will consider transferable skills from previous roles.

Gallagher is an affirmative action/equal opportunity employer (Minorities/Females/Veterans/Disabled)

Required:

• Degree from applicable program of training and a minimum of 3 years clinical experience in an acute care setting required.
• Active Registered Nursing license or equivalent within the state of practice or states in which Case Management is performed.

Preferred:

• Bachelor's degree preferred.
• Certification in related field preferred.
• Experience in care navigation, case management, or a related field is preferred.
• Strong understanding of health benefits and insurance plans.
• Excellent communication and interpersonal skills.
• Experience in scheduling and coordinating healthcare services.
• Compassionate and patient-centered approach to care.
• Ability to communicate effectively in English and Spanish preferred.

Behaviors:

• Demonstrates adequate knowledge of managed care with emphasis on use of criteria, guidelines and national standards of practice.
• Demonstrates good written and oral communications, organizational and leadership skills.
• Ability to work collaboratively in a team environment.
• Ability to educate and empower members regarding their health and wellness.
• Skilled in Microsoft 365 suite, electronic charting systems, and remote collaboration tools.
• Demonstrates good time management skills.
• Comfortable adjusting to evolving workflows and team needs.
• Takes initiative in problem-solving and process improvement.
• Current nursing license(s) to be maintained and willing to pursue additional licensure as business needs arise.

#LI-REMOTE #LI-HL1 #GBNursing