Prior Authorization Nurse - LPN

At Gillette Children’s, we foster a culture where every team member feels a sense of belonging and purpose. We are dedicated to building an environment where all feel welcomed, respected, and supported. Our values are embedded at the heart of our culture. We act first from love, embrace the bigger picture, and work side-by-side with our patients, families, and colleagues to help every child create their own story. Together, we work to ensure patients of all backgrounds and abilities reach their full potential.

1.0 FTE (40 hrs/wk); Monday - Friday, business hours. This position requires initial on-site training, and then will transition to a fully remote role once training is completed. On-site training will be located at the 455 Phalen location in St. Paul. This is a remote opportunity; however, the selected candidate must reside in Minnesota or Wisconsin and have the ability to work onsite in St. Paul, MN as needed Licensure through the MN Board of Nursing is required along with a minimum of one year nursing experience in a healthcare environment. Purpose Of Position: This position exists to promote the quality and cost effectiveness of medical care by applying clinical acumen and the appropriate application of policies and guidelines to the request for prior authorization. Compensation And Benefits Information The hourly wage for this opportunity is $23.98 to $35.97, with a median wage of $29.97/hour. Pay is dependent on several factors including relevant work experience, education, certification & licensure, and internal equity. Hourly pay is just one part of the compensation package for employees. Gillette supports career progression and offers a competitive benefits package that includes a retirement savings match, tuition and certification reimbursement, paid time off, and health and wellness benefits for .5 FTE and above.

Perform the processing of authorizations, certifications and referrals needed from payers in order to allow reimbursement at the highest levels for both the patient and for the organization. Utilize available resources for checking patient insurance benefits and eligibility to determine prior authorization requirements, and to better inform our patients of their estimated financial liability. Must abide by all Joint Commission requirements including, but not limited to, sensitivity to cultural diversity, patient care, patients' rights and ethical treatment, safety and security of physical environments, emergency management, teamwork, respect for others, participation in ongoing education and training, communication and adherence to safety and quality programs, sustaining compliance with National Patient Safety Goals, and licensure and health screenings. This position is responsible for maintaining professional and ethical behavior at all times as outlined by licensing guidelines and company policies.