Why work for Nebraska Methodist Health System?
At Nebraska Methodist Health System, we focus on providing exceptional care to the communities we serve and people we employ. We call it The Meaning of Care – a culture that has and will continue to set us apart. It’s helping families grow by making each delivery special, conveying a difficult diagnosis with a compassionate touch, going above and beyond for a patient’s needs, or giving a high five when a patient beats a disease or conquers a personal health challenge. We offer competitive pay, excellent benefits and a great work environment where all employees are valued! Most importantly, our employees are part of a team that makes a real difference in the communities we live and work in.

Job Summary:

Location: Methodist Corporate Office
Address: 825 S 169th St. - Omaha, NE

Work Schedule: Mon - Fri, 8:00am to 4:30pm or 8:30am to 5:00pm

Responsible for overseeing the day-to-day operations of multiple Pre-Access teams, with a specific focus on clinical oversight, prior authorizations, and denial prevention. This position ensures high-quality performance, provides leadership to licensed nursing/clinical staff and Pre-Access Advocates, and collaborates with leadership to drive long-term planning and growth of pre-access services. This role combines clinical expertise with operational leadership to support effective and compliant revenue cycle functions.

Responsibilities:

Essential Job Functions

Supervise daily operations of assigned Pre-Access teams, ensuring compliance with protocols and payer requirements.

Oversee and perform prior authorizations for scheduled and same-day procedures.

Monitor team performance, conduct quality audits, and communicate trends and areas for improvement.

Serve as the clinical resource for Pre-Access staff, offering guidance and support related to medical necessity, documentation, and payer criteria.

Allocate resources and manage staffing to meet departmental productivity and quality benchmarks.

Collaborate with providers, coding, and clinic staff to reduce denials and improve pre-authorization efficiency.

Triage system issues and escalate to appropriate departments when necessary.

Support hiring, onboarding, training, and performance evaluations in partnership with leadership.

Maintain and update payer reference materials and communicate changes effectively to staff.

Serve as a liaison between staff, providers, and leadership to ensure effective communication and coordination.

Address customer service concerns and assist in resolving complex authorization or clinical issues.

Schedule:

Mon - Fri, 8:00am to 4:30pm or 8:30am to 5:00pm

Job Description:

Job Requirements

Education

• Graduate of an accredited nursing program required.

• Bachelor of Nursing (BSN) preferred.

Experience

• Minimum 3-5 years in a clinical, billing, or pre-authorization environment required.

• Extensive knowledge of payer guidelines and pre-authorization tools required.

• Previous supervisory or team leadership experience preferred.

License/Certifications

• Current Registered Nurse (RN) license required.

Skills/Knowledge/Abilities

• Strong understanding of medical terminology, documentation, treatment guidelines, and reimbursement criteria.

• Ability to lead, coach, and develop staff in a fast-paced environment.

• Excellent verbal and written communication skills.

• Strong organizational and problem-solving abilities.

• Proficient in Microsoft Office (Word, Excel, Outlook).

• Capable of managing multiple priorities under tight deadlines.

Physical Requirements

Weight Demands

• Light Work - Exerting up to 20 pounds of force.

Physical Activity

• Not necessary for the position (0%):

  • Climbing

  • Crawling

  • Kneeling

• Occasionally Performed (1%-33%):

  • Balancing

  • Crouching

  • Distinguish colors

  • Lifting

  • Speaking/talking

  • Standing

  • Stooping/bending

  • Twisting

  • Walking

• Frequently Performed (34%-66%):

  • Grasping

  • Keyboarding/typing

  • Pulling/Pushing

  • Reaching

  • Repetitive Motions

  • Sitting

• Constantly Performed (67%-100%):

  • Hearing

  • Seeing/Visual

Job Hazards

• Not Related:

  • Chemical agents (Toxic, Corrosive, Flammable, Latex)

  • Biological agents (primary air born and blood born viruses) (Jobs with Patient contact) (BBF)

  • Physical hazards (noise, temperature, lighting, wet floors, outdoors, sharps) (more than ordinary office environment)

  • Equipment/Machinery/Tools

  • Explosives (pressurized gas)

  • Electrical Shock/Static

  • Radiation Alpha, Beta and Gamma (particles such as X-ray, Cat Scan, Gamma Knife, etc.)

  • Radiation Non-Ionizing (Ultraviolet, visible light, infrared and microwaves that causes injuries to tissue or thermal or photochemical means)

  • Mechanical moving parts/vibrations

About Methodist:

Nebraska Methodist Health System is made up of four hospitals in Nebraska and southwest Iowa, more than 30 clinic locations, a nursing and allied health college, and a medical supply distributorship and central laundry facility. From the day Methodist Hospital was chartered in 1891, service to our communities has been a top priority. Financial assistance, health education, outreach to our diverse communities and populations, and other community benefit activities have always been central to our mission.

Nebraska Methodist Health System is an Affirmative Action/Equal Opportunity Employer and does not discriminate on the basis of race, color, religion, sex, age, national origin, disability, veteran status, sexual orientation, gender identity, or any other classification protected by Federal, state or local law.