Remote Prior Authorization Rn Jobs in Baton Rouge, LA

Job Description:

The RN Hospital Care Manager I delivers comprehensive care management services to designated patients, leveraging clinical expertise for screenings, assessments, and evaluations. This role involves developing and implementing patient-centered care plans with shared goals and tailored interventions. The Care Manager collaborates seamlessly with patients, families/caregivers, healthcare providers, payers, community-based providers, and other stakeholders to ensure efficient, effective, and patient-focused care management. This position spans various departments, including both Inpatient and Outpatient areas.

Shift Details:

Saturday and Sunday - 0800-1630

Essential Functions

• Assessment: Identifies patients using screening criteria and conduct comprehensive evaluations.
• Care Planning: Develops, adjusts, and coordinates care plans to address medical and social needs.
• Patient Support: Guides self-management using motivational interviewing and coaching.
• Education & Advocacy: Provides education to healthcare teams and patients, advocate for patient rights, and support self-care.
• Collaboration: Works with multidisciplinary teams to ensure timely, high-quality care.
• Process Improvement: Leads initiatives to enhance care transitions and policy adherence.
• Advanced Care Planning: Provides Goals of Care education for informed decision-making.
• Data Analysis & Compliance: Tracks key metrics, analyze trends, and ensure regulatory compliance.

Skills

• Assessment
• Care Planning
• Motivational Interviewing
• Critical Thinking
• Time Management
• Customer Service
• Patient Education
• Communication
• Prioritization

Minimum Qualifications

• Current Registered Nurse (RN) license in state of practice.
• Bachelor of Science in Nursing (BSN) from an accredited institution (degree verification required). RNs hired or promoted into this role must obtain their BSN within four (4) years of their hire or promotion date. If there is an existing education agreement, that agreement will take precedence.
• Demonstrated clinical nursing experience in an inpatient hospital setting, and familiarity with hospital patient-related terminology and processes.
• Demonstrated understanding of disease management including treatment, length of stay, identifying barriers to delivery of care and any variation.

Preferred Qualification

• Bachelor of Science in Nursing (BSN) from an accredited institution.
• Case Management Certification
• Demonstrated experience in case management, utilization review, value-based care, and/or discharge planning.
• Basic computer skills, including proficiency in word processing and spreadsheet software. Intermediate knowledge of word processing and Excel software.

Physical Requirements

• Ongoing need for employee to see and read information, labels, documents, monitors, identify equipment and supplies, and be able to assess customer needs.
• Frequent interactions with providers, colleagues, customers, patients/clients, and visitors that require employee to verbally communicate as well as hear and understand spoken information, needs, and issues quickly and accurately.
• Manual dexterity of hands and fingers to manipulate complex and delicate supplies and equipment with precision and accuracy. This includes frequent computer use for typing, accessing needed information, etc.
• Mental stamina and flexibility- ability to handle high stress situations, make quick decisions, and manage multiple tasks simultaneously.
• For roles requiring driving: Expected to drive a vehicle which requires sitting, seeing, and reading signs, traffic signals, and other vehicles.

Location:

St. Marys Regional Hospital

Work City:

Grand Junction

Work State:

Colorado

Scheduled Weekly Hours:

16

The hourly range for this position is listed below. Actual hourly rate dependent upon experience.

$41.20 - $62.17

We care about your well-being - mind, body, and spirit - which is why we provide our caregivers a generous benefits package that covers a wide range of programs to foster a sustainable culture of wellness that encompasses living healthy, happy, secure, connected, and engaged.

Learn more about our comprehensive benefits package here.

By applying for a position with Intermountain, I acknowledge that I will comply with all applicable Intermountain policies and expectations. If applying for a remote or hybrid role, this includes remote work expectations related to confidentiality, information security, work schedules, conflicts of interest, and use of company equipment. I further acknowledge that outside employment or activities may not interfere with job responsibilities or create a conflict of interest with Intermountain. Actual or reasonably perceived conflicts may be grounds for disqualification from consideration or, if hired, corrective action up to and including termination of employment.

Intermountain Health is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.

At Intermountain Health, we usethe artificial intelligence ("AI") platform, HiredScore to improve your job application experience.HiredScore helps match your skills and experiences to the best jobs for you. WhileHiredScore assists in reviewing applications, all final decisions are made byIntermountain personnel to ensure fairness. We protect your privacy and follow strict data protection rules. Your information is safe and used only for recruitment. Thank you for considering a career with us and experiencing our AI-enhanced recruitment process.

All positions subject to close without notice.