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Sr RN, Telehealth
Ref No.: 18-29587
Location: Minneapolis, Virginia
Alternate title: Therapy Access Analyst

Contractor will go through a 1 week training period with the team on site during normal business hours. This role will be 20hrs week and they need to site on site at Healthcare. The hours are flexible between 8am-5pm and the candidate can work our a schedule with the manager once selected for hire.

The Therapy Access Analyst will support patient access to interventional pain therapies by working primarily with surgeons and their office staffs but also with hospitals and patients to support and inform regarding appropriate actions for medical necessity and prior authorization. This position will also assist in keeping other members of the Reimbursement team and sales representatives informed on issues and trends in new technology reimbursement. Interface with commercial payers is a significant part of this position. All work will be done within approved guidelines, policies and procedures and will most often be delivered telephonically. The position requires exceptional verbal and writing skills.

ESSENTIAL DUTIES AND RESPONSIBILITIES include the following. Other duties may be assigned.

Assist surgeon customers, hospitals and patients in understanding details of prior authorization, reimbursement, and denial management for interventional pain therapies.

Interface with payers in these processes.

Provide guidance to stakeholders on reimbursement and payer processes telephonically or in person as necessary.

Work within the guidelines, policies and procedures using clinical background, knowledge and skills.

Complete documentation, paperwork and required reports in a timely and comprehensive manner as outlined and specified.

Stay up to date and informed on commercial and governmental payer coverage to support stakeholder efforts.

Work in collaboration with Reimbursement Team to identify issues and strategies for their territories.

Interface with sales representatives on relevant issues and information.

Collaborate on the development of collateral materials.

Required:

Nursing degree from an accredited nursing school, college or university or a bachelor’s degree in a relevant field.

Minimum of 5 years experience in nursing, business office or other related healthcare positions showing progressive advancement through promotion, greater responsibility or acquisition of new job skills.

Understanding of healthcare payment processes, reimbursement and coverage issues.


Preferred: Experience in utilization review or care management