RN Care Manager-Insurance Authorization & Infusion Corinthian Health Services Dallas-Fort Worth, TX Job Details Full-time $78,000 - $80,000 a year 1 day ago Benefits Health savings account Disability insurance Health insurance Dental insurance 401(k) Flexible spending account Paid time off Employee assistance program Vision insurance 401(k) matching Flexible schedule Life insurance Paid sick time Qualifications Collaborate with healthcare professionals Teamwork Medicare RN License Managing patients as a nurse case manager Pre-authorization review for utilization management Attention to detail Patient care Computer skills Patient education Documentation review Time management Full Job Description Corinthian Health Services, Inc is seeking an experienced, compassionate, and highly organized Registered Nurse (RN) Care Manager with direct health insurance verification and prior authorization experience to join our team. This is not a traditional home health, bedside nursing, or general care-coordination position . The RN Care Manager is responsible for navigating insurance benefits and payer requirements to help our patients obtain authorization and access to prescribed infusion therapy. The ideal candidate has hands-on experience working directly with commercial health plans, Medicare and/or other payers to verify benefits, obtain prior authorizations, coordinate required documentation, and resolve barriers to treatment. If you are a self-motivated RN who enjoys working independently while being part of a collaborative, patient-focused team, we would love to hear from you. This position requires consistent availability during established business hours (8-5pm CST) to collaborate with patients, providers, payers, infusion sites, and team members. What You'll Do As an RN Care Manager, you will: Perform and coordinate insurance benefit verification for patients receiving prescribed infusion therapy. Obtain and manage prior authorizations from insurance payers, including gathering and submitting required clinical documentation. Communicate directly with payers regarding eligibility, benefits, coverage requirements, authorization criteria, medical necessity documentation, and authorization status. Identify missing information or payer requirements that could delay treatment and proactively work with providers, patients, infusion sites, and payers to resolve them. Track authorization requests through determination and maintain accurate documentation of payer communications, requirements, approvals, and outstanding items. Help create a positive, seamless infusion therapy experience by coordinating information among patients, prescribing physicians, clinical professionals, infusion sites, and insurance payers. Identify barriers to treatment and connect patients with available resources, including transportation assistance, advocacy resources, and copay or financial assistance programs. Collaborate with physicians and infusion nurses to support positive patient outcomes and identify treatment-related concerns. Serve as a knowledgeable and compassionate resource for patients navigating complex healthcare and insurance processes. Independently manage assigned responsibilities and priorities while contributing to a supportive, team-oriented environment.

What We're Looking For Required Qualifications:

Current, unrestricted Registered Nurse (RN) license in the state in which you will physically perform your work. Minimum of FIVE years of clinical nursing experience . Minimum of TWO years of direct professional experience performing health insurance benefit verification and performing prior authorizations from insurance payers. Experience communication directly with insurance companies regarding coverage requirements, authorization status, clinical documentation, and payer requirements. Experience reviewing clinical documentation and coordinating information necessary to support authorization of medical treatment. Excellent organizational and time-management skills with the ability to manage multiple priorities. Strong understanding of health insurance terminology, benefits, eligibility, medical necessity, prior authorization, and payer processes. Ability to independently follow an authorization from initial verification through determination and resolve outstanding requirements or barriers. Strong clinical judgment and problem-solving abilities. Excellent verbal, written, and interpersonal communication skills. Ability to manage a large number of patients, payer requirements, deadlines, and priorities in a remote environment. Communicate complex clinical and insurance information to patients in a clear, compassionate, and understandable manner. Strong technology skills and comfort working independently in a remote environment. Reliable, self-motivated, detail-oriented, and able to work effectively as part of a collaborative team.

Preferred Qualifications:

Infusion therapy experience. Experience with specialty medications or biologic therapies. Experience obtaining authorization for infusion therapies, specialty medications, or other high-cost therapies. Experience with commercial insurance, Medicare, and specialty pharmacy/payer processes. Experience with denials, appeals, peer-to-peer coordination, copay assistance, or patient financial assistance programs. Previous remote RN case-management experience. Schedule & Work Environment Full-time, salaried position Monday-Friday 8:00 AM-5:00 PM Central Time Remote This position requires consistent availability during established business hours to collaborate with patients, providers, payers, infusion sites, and team members. The role involves extended periods of computer work and frequent telephone and electronic communication. Compensation $78,000-$80,000 per year , based on relevant experience and qualifications. Benefits Corinthian Health Services, Inc. offers a comprehensive benefits package that includes: Medical insurance Dental insurance Vision insurance 401(k) retirement plan 401(k) company match Health Savings Account (HSA) Flexible Spending Account (FSA) Life insurance Disability insurance Employee Assistance Program Paid time off Paid sick time About Corinthian Health Corinthian Health is committed to delivering exceptional service and building lasting relationships with clients and partners. We foster a culture of teamwork, integrity, accountability, respect, and fun.

Job Type:

Full-time Pay:

$78,000.00 - $80,000.00 per year

Benefits:

401(k) matching Dental insurance Employee assistance program Flexible schedule Flexible spending account Health insurance Life insurance Paid time off Vision insurance Application Question(s): Do you have a dedicated home-office space and are you able to work remotely without distraction Monday-Friday 8am-5pm CST? Describe your direct experience verifying health insurance benefits and obtaining prior authorizations from insurance payers. What types of services, medications, or treatments were you obtaining authorizations for? In your most recent position, approximately what percentage of your work involved insurance verification, prior authorizations, or direct communication with insurance payers? Please describe.

License/Certification:

RN License (Required)

Location:

Texas (Required)

Work Location:

Remote