Remote Prior Authorization Rn Jobs in Woodbridge, VA

Thank you for your interest in joining Solventum. Solventum is a new healthcare company with a long legacy of solving big challenges that improve lives and help healthcare professionals perform at their best. At Solventum, people are at the heart of every innovation we pursue. Guided by empathy, insight, and clinical intelligence, we collaborate with the best minds in healthcare to address our customers' toughest challenges. While we continue updating the Solventum Careers Page and applicant materials, some documents may still reflect legacy branding. Please note that all listed roles are Solventum positions, and our Privacy Policy: https://www.solventum.com/en-us/home/legal/website-privacy-statement/applicant-privacy/ applies to any personal information you submit. As it was with 3M, at Solventum all qualified applicants will receive consideration for employment without regard to their race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

Job Description:

CDI Outsourcing Manager - Remote (Solventum)

3M Health Care is now Solventum

At Solventum, we enable better, smarter, safer healthcare to improve lives. As a new company with a long legacy of creating breakthrough solutions for our customers' toughest challenges, we pioneer game-changing innovations at the intersection of health, material and data science that change patients' lives for the better while enabling healthcare professionals to perform at their best. Because people, and their wellbeing, are at the heart of every scientific advancement we pursue.

We partner closely with the brightest minds in healthcare to ensure that every solution we create melds the latest technology with compassion and empathy. Because at Solventum, we never stop solving for you.

The Impact You'll Make in this Role

As a CDI Outsourcing Manager, you will have the opportunity to tap into your curiosity and collaborate with some of the most innovative and diverse people around the world. Here, you will make an impact by:

• Assume responsibility/overall management for the assigned outsourced CDI engagements that are either supplemental or total outsourced programs while assisting Consulting Services in obtaining set revenue goals.

• Monitors and manages relationships with contracted vendors and facilitates the resolution of issues and conflicts

• Directly supervise and provide expertise to the CDI staff to assure target quality and production levels

• Continually measure the effectiveness of CDI operations, identify areas for improvement, monitor trends and develop plans of action for and any identified problem areas

• Provides direct supervision to assigned CDI through leadership, coaching, training and development, allocating work assignments, review of progress in achieving objectives, managing employee compensation, performance appraisals, diversity, disability, all relevant employee data, etc. Understands and enforces corporate/location policies and procedures. Takes appropriate action to address policy violations.

Your Skills and Expertise

To set you up for success in this role from day one, Solventum requires (at a minimum) the following qualifications:

• Bachelor's Degree or higher (completed and verified prior to start) from an accredited institution

AND seven (7) years of acute care CDI management experience.

OR

• High School Diploma/GED from AND eleven (11) years of acute care CDI management experience.

AND

In addition to the above requirements, the following are also required:

• CCDS certification or valid RN license with minimum of five (5) years acute care experience

• Ability to travel up to 50% of the time

Additional qualifications that could help you succeed even further in this role include:

• Master's degree in HIM, Nursing, or other healthcare clinical background from an accredited institution

• Preferred 10+ years in management of CDI or Health Information Management (HIM) services consulting or coding functions in mid-to-large size acute care hospital setting or 10+ years in management of outsourced CDI group

• Strong ICD-10-CM/PCS coding, ICD-10-CM/PCS Coding Guidelines and DRG methodologies experience; Working knowledge of risk-adjusted methodologies (e.g., APR DRGs) and quality of care measures (e.g., HACs, PSIs)

• Deep understanding of clinical documentation, medical record coding, healthcare billing and revenue cycle management

• Attention to detail, highly organized, with an absolute focus on quality of work. Proven ability to manage multiple tasks, meet deadlines, work independently and produce excellent results

Work location:

• Remote

Travel: May include up to 50% domestic

Relocation Assistance: Not authorized

Must be legally authorized to work in country of employment without sponsorship for employment visa status (e.g., H1B status).

Supporting Your Well-being

Solventum offers many programs to help you live your best life - both physically and financially. To ensure competitive pay and benefits, Solventum regularly benchmarks with other companies that are comparable in size and scope.

Onboarding Requirement: To improve the onboarding experience, you will have an opportunity to meet with your manager and other new employees as part of the Solventum new employee orientation. As a result, new employees hired for this position will be required to travel to a designated company location for on-site onboarding during their initial days of employment. Travel arrangements and related expenses will be coordinated and paid for by the company in accordance with its travel policy. Applies to new hires with a start date of October 1st 2025 or later.Applicable to US Applicants Only:The expected compensation range for this position is $125,600 - $172,700, which includes base pay plus variable incentive pay, if eligible. This range represents a good faith estimate for this position. The specific compensation offered to a candidate may vary based on factors including, but not limited to, the candidate's relevant knowledge, training, skills, work location, and/or experience. In addition, this position may be eligible for a range of benefits (e.g., Medical, Dental & Vision, Health Savings Accounts, Health Care & Dependent Care Flexible Spending Accounts, Disability Benefits, Life Insurance, Voluntary Benefits, Paid Absences and Retirement Benefits, etc.). Additional information is available at: https://www.solventum.com/en-us/home/our-company/careers/#Total-RewardsResponsibilities of this position include that corporate policies, procedures and security standards are complied with while performing assigned duties.

Solventum is committed to maintaining the highest standards of integrity and professionalism in our recruitment process. Applicants must remain alert to fraudulent job postings and recruitment schemes that falsely claim to represent Solventum and seek to exploit job seekers.

Please note that all email communications from Solventum regarding job opportunities with the company will be from an email with a domain of @solventum.com. Be wary of unsolicited emails or messages regarding Solventum job opportunities from emails with other email domains.

Please note, Solventum does not expect candidates in this position to perform work in the unincorporated areas of Los Angeles County.Solventum is an equal opportunity employer. Solventum will not discriminate against any applicant for employment on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, or veteran status.

Please note: your application may not be considered if you do not provide your education and work history, either by: 1) uploading a resume, or 2) entering the information into the application fields directly.

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