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Description

Introduction

Do you have the career opportunities as a(an) Insurance Case Manager you want with your current employer? We have an exciting opportunity for you to join HCA Florida North Florida Hospital which is part of the nation's leading provider of healthcare services, HCA Healthcare.

Benefits

HCA Florida North Florida Hospital offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include:

+ Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical transportation.

+ Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more.

+ Free counseling services and resources for emotional, physical and financial wellbeing

+ 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service)

+ Employee Stock Purchase Plan with 10% off HCA Healthcare stock

+ Family support through fertility and family building benefits with Progyny and adoption assistance.

+ Referral services for child, elder and pet care, home and auto repair, event planning and more

+ Consumer discounts through Abenity and Consumer Discounts

+ Retirement readiness, rollover assistance services and preferred banking partnerships

+ Education assistance (tuition, student loan, certification support, dependent scholarships)

+ Colleague recognition program

+ Time Away From Work Program (paid time off, paid family leave, long- and short-term disability coverage and leaves of absence)

+ Employee Health Assistance Fund that offers free employee-only coverage to full-time and part-time colleagues based on income.

Learn more about Employee Benefits (https://careers.hcahealthcare.com/pages/employee-benefits-and-rewards)

_Note: Eligibility for benefits may vary by location._

Our teams are a committed, caring group of colleagues. Do you want to work as a(an) Insurance Case Manager where your passion for creating positive patient interactions is valued? If you are dedicated to caring for the well-being of others, this could be your next opportunity. We want your knowledge and expertise!

Job Summary and Qualifications

In this role you will:

+ Oversee all aspects of transplant authorization and medical management authorization.

+ Manage the transplant authorization process for assigned cases.

+ Act as a liaison between clinical staff, physicians, and hospital departments to address escalated financial clearance matters.

+ Completely and accurately obtains/maintains transplant benefits and insurance verification on patients presenting for transplant services and/or organ failure services during all phases of transplant care.

+ Consistently meets deadlines and turn-around times to ensure authorizations are obtained timely.

+ Manages all aspects of the transplant authorization process for assigned cases, which includes periodic re-verification of patients managed by the transplant program.

+ Maintains and updates clinic and case management personnel on patient status, including patients who require additional testing for continued authorization, communication about authorization, and case closures with the insurance company.

+ Assists with the development of processes and procedures related to the financial coordinator and/or counselor role in collaboration with the Department Director.

+ Coordinates with clinicians to obtain authorizations for complex medical cases requiring additional clinical documentation or peer-to-peer review.

+ Provides direction and support to Financial Coordinators and/or Financial Counselors on interpreting and understanding payor medical coverage policies and authorization requirements.

+ Acts as a liaison to assist in maintaining effective relationships with clinical staff, physicians, and hospital departments by addressing escalated financial clearance matters.

+ Supports the patient financial counseling process, which may include conducting patient education classes, financial counseling, and/or attending patient tracking meetings as designated.

+ Coordinates with clinical case management, patient access, insurance case management, clinic personnel, and physicians to ensure transplant-related cases are reviewed for financial clearance, insurance selection, and authorization.

+ Demonstrates proficiency in all areas related to Global Billing/Reimbursement for cross-coverage on duties that are not equally shared.

+ Supports the mission and vision of the Methodist Healthcare System.

+ Complies with System and facility safety policies and rules.

+ Adheres to the MHS Code of Conduct and demonstrates ethical behavior.

+ Completes other duties as assigned.

What qualifications you will need:

+ Minimum of 2 years of direct experience with transplant financial clearance or clinical authorization with case management.

+ College degree or 4 years of related work experience in a healthcare setting.

HCA Florida North Florida Hospital is a 523-bed, full-service medical and surgical acute care center. For over 49 years, we have served North Central Florida. We offer comprehensive cardiovascular care, oncology, orthopedics, and neurosciences. We offer minimally-invasive laparoscopic and robotic surgery, weight loss surgery and treatment. Other services that we provide include women’s health and wound therapy. We are fully accredited by the Joint Commission and certified as a Comprehensive Stroke Center. Our hospital has an Accredited Chest Pain Center by ACC (American College of Cardiology) and is designated as a Blue Distinction Center for Spine Surgery and Bariatric Surgery. We are committed to patient safety and quality of care. We have received the highest scores available in recognition of this commitment.

HCA Healthcare has been recognized as one of the World’s Most Ethical Companies® by the Ethisphere Institute more than ten times. In recent years, HCA Healthcare spent an estimated $3.7 billion in cost for the delivery of charitable care, uninsured discounts, and other uncompensated expenses.

"Bricks and mortar do not make a hospital. People do."- Dr. Thomas Frist, Sr.

HCA Healthcare Co-Founder

If you are looking for an opportunity that provides satisfaction and personal growth, we encourage you to apply for our Insurance Case Manager opening. We promptly review all applications. Highly qualified candidates will be contacted for interviews. **Unlock the possibilities and apply today!**

We are an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.