Infusion Insurance and Prior Authorization Mgr (IL)

Prime Healthcare is an award-winning health system headquartered in Ontario, California. Prime Healthcare operates 45 hospitals and has more than 300 outpatient locations in 14 states providing more than 2.6 million patient visits annually. It is one of the nation's leading health systems with nearly 50,000 employees and physicians. Fourteen of the Prime Healthcare hospitals are members of the Prime Healthcare Foundation, a 501(c)(3) not-for-profit public charity. Prime Healthcare is actively seeking new members to join our corporate team!

Company is an equal employment opportunity employer. Company prohibits discrimination against any applicant or employee based on race, color, sex, sexual orientation, gender identity, religion, national origin, age (subject to applicable law), disability, military status, genetic information or any other basis protected by applicable federal, state, or local laws. The Company also prohibits harassment of applicants or employees based on any of these protected categories. Know Your Rights: https://www.eeoc.gov/sites/default/files/2022-10/EEOC_KnowYourRights_screen_reader_10_20.pdf

The Infusion Insurance and Prior Authorization Manager manages the daily operations of patient scheduling, registration, admission and prior authorization. This manager ensures effective communication with internal and external customers if there are potential problems and identifies solutions related to financial clearance and scheduling patients for infusion therapy.

EDUCATION, EXPERIENCE, TRAINING

Required qualifications:

High school diploma or equivalent required.
1. At least 3 years of experience in registration or prior authorization operations required.
2. Critical thinking, decisive judgment, and leadership skills are required.
3. Excellent communication, organizational, and customer service skills are required.
4. Ability to work with minimal supervision required.

Preferred qualification:

1. 1 year of leadership or management experience.
2. Proficiency in Meditech and Epic electronic medical records (EMR) systems.
3. Advanced knowledge and experience in infusion prior authorizations and medical necessity preferred.