Clinic Nurse (Prior Authorizations)

Brightli • Sedalia, MO

9d

About The Position

CLINIC NURSE (PRIOR AUTHORIZATIONS) Sedalia, Missouri Full-Time - Mon to Fri 8am-5pm No weekends or holidays! No on-call requirement! Highly competitive pay - based on license & experience Employee benefits package - health, dental, PTO, & more Top-notch training - initial and ongoing Culture & Environment - welcoming and supportive As a Prior Authorization Nurse at Burrell Behavioral Health, you will be responsible for managing the prior authorization process for medications, treatments, and other healthcare services. This includes communicating with insurance companies, gathering clinical information, and ensuring that all necessary authorizations are obtained in a timely manner. Prior Authorization Key Responsibilities Coordinate with insurance companies to obtain prior authorization for medications, treatments, and other healthcare services Gather clinical information and document appropriately to support prior authorization requests Communicate effectively with providers, patients, and family members regarding prior authorization status and any necessary additional information Manage and maintain accurate records of prior authorization requests, approvals, and denials Identify and communicate potential issues or concerns related to prior authorization and work collaboratively with the healthcare team to resolve them Stay current with changes in insurance policies and procedures related to prior authorization and communicate these changes to the healthcare team Participate in quality improvement initiatives to improve the prior authorization process and ensure optimal patient care Clinic Nurse Key Responsibilities Deliver compassionate and personalized nursing care, prioritizing the needs and well-being of clients in every interaction while allowing room for flexibility. Skillfully execute physician's orders, ensuring coordinated healthcare services and promoting a seamless patient experience, taking into account individual preferences and adapting as necessary. Carry out essential nursing responsibilities, including accurate temperature and blood pressure measurements, fostering a sense of comfort and confidence in clients through attention to detail and thoroughness. Engage in detailed interviews with clients and their families, actively seeking to understand their medical background and medication history in order to provide comprehensive and individualized care plans, paying attention to specific preferences and accommodating accordingly. Maintain and update patient documentation, ensuring accurate and up-to-date records to facilitate effective communication and coordination among healthcare professionals, while recognizing the importance of accuracy and precision. Monitor and manage medical administration records (MARs) and handle medication prescribing authorities (PA's) proficiently, prioritizing patient safety and adhering to protocols, with a focus on organization and thoroughness. Serve as a valuable resource for nursing and medical inquiries, offering guidance and expertise to colleagues, clients, and their families, fostering collaboration and support within the healthcare community, keeping in mind the desire for continuous learning and growth. If you're ready to join a team of dedicated professionals who are passionate about delivering exceptional care, we encourage you to apply for this exciting opportunity. At Burrell Behavioral Health, we value continuous learning, growth, and work-life balance, and we look forward to discussing how you can contribute to our mission. Position Perks & Benefits: Paid time off: full-time employees receive an attractive time off package to balance your work and personal life Employee benefits package: full-time employees receive health, dental, vision, retirement, life, & more Top-notch training: initial, ongoing, comprehensive, and supportive Career mobility: advancement opportunities/promoting from within Welcoming, warm, supportive: a work culture & environment that promotes your well-being, values you as human being, and encourages your health and happiness. Brightli is on a Mission: A mission to improve client care, reduce the financial burden of community mental health centers by sharing resources, a mission to have a larger voice in advocacy to increase access to mental health and substance user care in our communities, and a mission to evolve the behavioral health industry to better meet the needs of our clients. As a behavioral and community mental health provider, we prioritize fostering a culture of belonging and connection within our workforce. We encourage applications from individuals with varied backgrounds and experiences, as we believe that a rich tapestry of perspectives strengthens our mission. If you are passionate about empowering local communities and creating an environment where everyone feels valued and supported, we invite you to join our mission-driven organization dedicated to cultivating an authentic workplace. We are an Equal Employment Opportunity Employer. Burrell Behavioral Health is a Smoke and Tobacco Free Workplace. About Brightli Brightli is on a mission: A mission to improve client care, reduce the financial burden of community mental health centers by sharing resources, a mission to have a larger voice in advocacy to increase access to mental health and substance use care in our communities, and a mission to evolve the behavioral health industry to better meet the needs of our clients. We are doing this by forming a new behavioral health organization under new model. Under one parent company, multiple organizations are able to collaborate, share resources and system supports, increase recruiting and retention efforts, increase access to specialized care, and meet the growing demand for behavioral and addiction recovery care. Brightli’s top-line subsidiaries include Burrell Behavioral Health (Burrell), Preferred Family Healthcare (PFH), Southeast Missouri Behavioral Health (SEMO), Firefly, Adult and Child Health, and Places for People. While these organizations operate independently and are governed by separate board of directors, their operations and services benefit from this model. Alone, organizations may be able to navigate the current tumultuous healthcare environment, but we believe that together we can do so much more than survive. Our communities need us now more than ever, and by working together we are ready to answer their call for years to come. Brightli Snapshot 200 locations 4 states 19 subsidiaries and/or affiliates 5k+ employees

Requirements

• Current RN (Registered Nurse) license in Missouri OR Current LPN (Licensed Practical Nurse) license in Missouri
• Strong knowledge of insurance policies and procedures related to prior authorization
• Excellent communication and organizational skills
• Ability to work effectively in a fast-paced, dynamic environment
• Demonstrated ability to work collaboratively with patients, families, and healthcare professionals
• Strong commitment to providing high-quality, patient-centered care

Responsibilities

• Coordinate with insurance companies to obtain prior authorization for medications, treatments, and other healthcare services
• Gather clinical information and document appropriately to support prior authorization requests
• Communicate effectively with providers, patients, and family members regarding prior authorization status and any necessary additional information
• Manage and maintain accurate records of prior authorization requests, approvals, and denials
• Identify and communicate potential issues or concerns related to prior authorization and work collaboratively with the healthcare team to resolve them
• Stay current with changes in insurance policies and procedures related to prior authorization and communicate these changes to the healthcare team
• Participate in quality improvement initiatives to improve the prior authorization process and ensure optimal patient care
• Deliver compassionate and personalized nursing care, prioritizing the needs and well-being of clients in every interaction while allowing room for flexibility.
• Skillfully execute physician's orders, ensuring coordinated healthcare services and promoting a seamless patient experience, taking into account individual preferences and adapting as necessary.
• Carry out essential nursing responsibilities, including accurate temperature and blood pressure measurements, fostering a sense of comfort and confidence in clients through attention to detail and thoroughness.
• Engage in detailed interviews with clients and their families, actively seeking to understand their medical background and medication history in order to provide comprehensive and individualized care plans, paying attention to specific preferences and accommodating accordingly.
• Maintain and update patient documentation, ensuring accurate and up-to-date records to facilitate effective communication and coordination among healthcare professionals, while recognizing the importance of accuracy and precision.
• Monitor and manage medical administration records (MARs) and handle medication prescribing authorities (PA's) proficiently, prioritizing patient safety and adhering to protocols, with a focus on organization and thoroughness.
• Serve as a valuable resource for nursing and medical inquiries, offering guidance and expertise to colleagues, clients, and their families, fostering collaboration and support within the healthcare community, keeping in mind the desire for continuous learning and growth.

Benefits

• Paid time off: full-time employees receive an attractive time off package to balance your work and personal life
• Employee benefits package: full-time employees receive health, dental, vision, retirement, life, & more
• Top-notch training: initial, ongoing, comprehensive, and supportive
• Career mobility: advancement opportunities/promoting from within
• Welcoming, warm, supportive: a work culture & environment that promotes your well-being, values you as human being, and encourages your health and happiness.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed
• Number of Employees: 5,001-10,000 employees