Remote Hybrid Supervisor Revenue Cycle Financial Clearance RN – MN or WI

Optum

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Requisition Number: 2220127
Job Category: Nursing
Primary Location: Minneapolis, MN
(Remote considered)

Opportunities at Optum, in strategic partnership with Allina Health. As an Optum employee, you will provide support to the Allina Health account. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.

The Supervisor Revenue Cycle Financial Clearance RN will be accountable for managing the daily prior authorization operational support for one service line across the system, including: staff supervision, issue resolution, individual productivity oversight, and acting as a technical resource.  Interacts with all Leaders of the service line for which the Supervisor is accountable.  Partners with Payor Relations to identify payor issues and trends system wide.  Provides ongoing support and developmental guidance by analyzing performance metrics, providing performance feedback, and conducting training and other educational opportunities. Acts as clinical resource to staff leading a team of nurses.

NOTE: Qualified candidate must reside in MN or WI to be considered for this position 

If you live in the state of Minnesota or Wisconsin, you will have the flexibility to work remotely* as you take on some tough challenges.

Primary Responsibilities:

  • Leads and coordinates ongoing staff evaluation, retention, training and management of policies and procedures:
    • Interviews and hires staff
    • Onboards, orients, and provides ongoing coaching, mentoring and support to staff. Models and teaches these skills to others
    • Manages and oversees staff performance through performance planning and coaching
    • Conducts annual evaluations and necessary corrective action for assigned staff
    • Manages staff quality and productivity; analyzes performance metrics to locate and resolve trends and issues. Establishes clear expectations and deliverables
    • Manages timekeeping and attendance
    • Collaborates with Manager of Financial Clearance to establish policies and procedures
    • Apprises and educates staff in new/changed regulations, policies and procedures, and compliance
    • Assesses training needs and works with appropriate teams to conduct training or other educational activities
    • Maintains open, effective communication with Manager of Financial Clearance regarding development and performance of direct reports
  • Coordinates the day-to-day support for staff and department:
    • Oversees and guide the day-to-day work of Prior Authorization staff
    • Responsible for all administrative functions that contribute to the management and execution of all Prior Authorization services
    • Ensures teams have the necessary tools and training to support appropriate clinical abstraction from patients records and interpretation of insurance payer medical policies, for authorization purposes
    • Coordination of staffing needs to support financial clearance of all scheduled patients prior to the date of service in compliance with Allina Health policies
    • Acts as a technical resource to staff and patients
    • Identifies, addresses and resolves workflow concerns
    • Oversees efforts of staff in coordinating with Scheduling to ensure resolution of relevant matters
    • Works with representatives from the Billing and Payor Relations departments to maintain knowledge of payer regulations and reimbursement requirements, as well as hospital/clinic charging and collection policies
    • Ensures that key performance metrics are met on a daily basis
  • Acts as a clinical resource:
    • Provides clinical knowledge and support with assessing clinical data, for authorization purposes
    • Coaches the team through resolution of accounts that are complex and require a higher degree of clinical expertise and critical thinking
    • Collaborates with nursing, physicians, legal, compliance, coding, billing, scheduling, and patient access staff to answer clinical questions related to prior authorizations
    • Works collaboratively with other departments and peers to identify and minimize barriers to providing coordinated excellent care
  • Works with the Manager of Financial Clearance on program development:
    • Executes and implements approved budgets and financials
    • May be responsible for communicating developed budgets and managing the developed budget
    • Coordinates with Manager of Financial Clearance to verify that all normal business operations are occurring timely, accurately, and the outcome is effective and aligned to maximize operational and financial performance
  • Other duties as assigned

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

  • Registered Nurse (RN) with an active, unrestricted RN License in the state of Minnesota (MN) or Wisconsin (WI)
  • 5+ years of Clinical experience in an acute hospital or medical clinic setting
  • 2+ years of health insurance authorization experience (on either the provider or payer side)
  • Experience working as a Supervisor with team/culture building for a large department
  • Lives in MN or WI to be eligible for consideration (regional travel will be needed on a routine basis as business needs dictate)
  • Willing to travel to onsite locations (primarily Minneapolis MN area) as business needs dictate (approximately 1-2 times per month or more)

Preferred Qualification:

  • Experience using InterQual, MCG, or other clinical criteria

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes – an enterprise priority reflected in our mission.