System Director, Authorization Management & Pre-Service

Location: Louisville, Kentucky
Job Category: Executive Leadership
Job ID:
Facility Group: Norton System Services


Job Description

Responsibilities

The System Director Authorization Management & Pre-Service leads and manages a team composed primarily of denial nurses, utilization review nurses (RN, LPN), pre-service and insurance verification representatives. This team develops processes for prospective, concurrent and retrospective utilization review. They provide timely notification of admission to third party payors and managed care companies. The team works closely with the hospital-based care managers and clinical offices to provide clinically accurate, timely and meaningful clinical reviews to payors in order to obtain authorizations. The System Director Authorization Management & Pre-Service collaborates with staff external to the organization (payors), as we...