Remote Prior Authorization Rn Jobs in Birmingham, AL

WHO IS GUIDEHEALTH? 

Guidehealth is a data-powered, performance-driven healthcare company dedicated to operational excellence. Our goal is to make great healthcare affordable, improve the health of patients, and restore the fulfillment of practicing medicine for providers. Driven by empathy and powered by AI and predictive analytics, Guidehealth leverages remotely-embedded Healthguides and a centralized Managed Service Organization to build stronger connections with patients and providers. Physician-led, Guidehealth empowers our partners to deliver high-quality healthcare focused on outcomes and value inside and outside the exam room for all patients. 

Join us as we put healthcare on a better path!!  

Job Description

Retinal Camera Operator - Eye Exam Specialist is primarily responsible for performing scheduled diabetic eye exams (retinal screenings) for members at the provider practice using imaging equipment supplied and trained on by the company. Travel to and from appointments is covered by the company.

Success in this role requires comfort operating specialized retinal imaging equipment (full training and camera provided), strong attention to detail, and a willingness to travel daily to provider practices for scheduled eye exam appointments.

WHAT YOU'LL BE DOING

• This role will require up to 100% paid field travel in the Philadelphia, PA area. Qualified candidates must reside locally.
• Working in a field-based role, traveling to provider practices and patient homes for scheduled eye exam appointments, while engaging virtually with team members, internal partners, customers, providers, payers, and care teams on non-appointment days.
• Traveling to provider practices on a scheduled appointment basis to perform diabetic eye exams (retinal screenings) using company-provided imaging equipment and supporting the closure of eye exam and related quality gaps.
• Completing company-provided training on retinal imaging equipment and eye exam procedures prior to conducting exams independently and maintaining competency through ongoing training as needed.
• Managing a daily eye exam appointment schedule, confirming appointments with practices and patients in advance, and coordinating travel logistics, with all mileage and travel expenses associated with eye exam visits being covered by the company.
• Building and maintaining strong working relationships with co-workers, customers, providers, payers, and care teams.
• Performing other duties as assigned to support quality improvement, reporting, patient outreach, and customer success.

WHAT YOU'LL NEED FOR SUCCESS

• Willingness and ability to travel daily, up to 100%, to provider practices to perform scheduled eye exams; no prior eye exam or imaging experience required, as full training and equipment are provided by the company. 
• Must have a valid driver's license and reliable transportation. 
• Associate degree or greater in a related field. 
• Minimum of 1-3 years of experience in a healthcare setting. 
• Knowledge of medical terminology, quality measures, medical billing, or coding. 
• Proficiency using Microsoft Excel, PowerPoint, Word, Outlook, Teams, and multiple healthcare-related systems or applications. 
• Strong verbal and written communication skills. 
• Strong attention to detail, organizational skills, and ability to meet hard deadlines. 
• Ability to collaborate effectively with management, co-workers, customers, providers, payers, and care teams. 
• Ability to work independently in a remote environment. 

WHAT WE'D LOVE FOR YOU TO HAVE

• Certified or licensed healthcare professional credential, such as Certified Medical Assistant (CMA) or Licensed Practical Nurse (LPN). 

The hourly rate for this role is $25/hour plus performance incentives, based upon experience, plus mileage reimbursement consistent with IRS guidelines.

ALIVE with Purpose: How We Thrive at Guidehealth 

At Guidehealth, our values come to life in everything we do. 

• We are Driven by Accountability - grounded in transparency, reliability, and integrity as we navigate challenges and opportunities alike. 
• Always Growing, Always Learning - staying curious and continuously improving inspires us to shape a better future for healthcare. 
• With Collaborative Innovation, we solve problems creatively, making every experience better for our employees and the patients we serve. 
• At Guidehealth, Every Voice Matters - we believe our collective strength is rooted in the unique perspectives of each team member. 
• And through Empathy in Action, we build stronger connections with those who count on us. 
• This is what it means to be ALIVE with purpose. This is how we thrive - together - at Guidehealth. 

BENEFITS:

While you are hard at work advancing value-based healthcare, we are here to ensure YOU have the care you and your family need and the opportunities for growth and development. Our commitments to you include:

• Work from Home: Guidehealth is a fully remote company, providing you the flexibility to spend less time commuting and more time focusing on your professional goals and personal needs.
• Keep Health a Priority: We offer comprehensive Medical, Dental, and Vision plans to keep you covered.
• Plan for the Future: Our 401(k) plan includes a 3% employer match to your 6% contribution.
• Have Peace of Mind: We provide Life and Disability insurance for those "just in case" moments. Additionally, we offer voluntary Life options to keep you and your loved ones protected.
• Feel Supported When You Need It Most: Our Employee Assistance Program (EAP) is here to help you through tough times.
• Take Time for Yourself: We offer paid time off plans helping you achieve work-life balance and meet your personal goals.
• Support Your New Family: Welcoming a new family member takes time and commitment. Guidehealth offers paid parental leave to give you the time you need.
• Learn and Grow: Your professional growth is important to us. Guidehealth offers various resources dedicated to your learning and development to advance your career with us.

All full-time employees of Guidehealth who work 30 hours per week or more are eligible for our comprehensive benefits package. Temporary employees and contractors are not eligible for benefits.

COMPENSATION:

The listed compensation range listed is paid bi-weekly per our standard payroll practices. Final base pay decisions are dependent upon a variety of factors which may include, but are not limited to: skill set, years of relevant experience, education, location, and licensure/certifications.

OUR COMMITMENT TO EQUAL OPPORTUNITY EMPLOYMENT 

Diversity, inclusion, and belonging are at the core of Guidehealth's values. We are an equal opportunity employer. We enthusiastically accept our responsibility to make employment decisions without regard to race, religious creed, color, age, sex, sexual orientation and identity, national origin, citizenship, religion, marital status, familial status, physical, sensory, or medical disability, Family and Medical Leave, military or veteran status, pregnancy, childbirth or other related medical conditions, or any other classification protected by federal, state, and local laws and ordinances. Our management is fully dedicated to ensuring the fulfillment of this policy with respect to hiring, placement, promotion, transfer, demotion, layoff, termination, recruitment advertising, pay, and other forms of compensation, training, and general treatment during employment. 

OUR COMITTMENT TO PROTECTION OF PATIENT AND COMPANY DATA

This position is responsible for following all Security policies and procedures in order to protect all PHI and PII under Guidehealth's custodianship as well as Guidehealth Intellectual Properties.  For any security-specific roles, the responsibilities would be further defined by the hiring manager. 

As a remote-first organization handling sensitive healthcare data, Guidehealth verifies candidate identity at multiple stages of the hiring and onboarding to safeguard patient privacy, data security, and compliance requirements.

REMOTE WORK TECHNICAL REQUIREMENTS
Guidehealth is a fully remote company. We provide new employees with the necessary equipment to function in their role at no charge to the employee. Employees provide their own internet connection, capable of conducting video calls on camera and connecting to various internal and external systems. The required internet speed is a minimum of 100 mbps download, 10 mbps upload. Please run a speed test here to confirm your internet connection meets these requirements. 

SECONDARY EMPLOYMENT

At Guidehealth, we value transparency and collaboration as part of our commitment to excellence. As your primary employer, we kindly ask all team members to disclose any secondary employment, regardless of whether it may present a potential conflict of interest. 

To ensure smooth teamwork and availability, employees must be accessible during our stated working hours. We foster connection and engagement by asking team members to join virtual meetings with their cameras on.