Authorizations & Transitions Specialist

PocketRN

Company Overview

PocketRN is the first telehealth startup built specifically for nurse-led care, with a mission to close the gap between home and healthcare by enabling patients to meet virtually with specialized nurses. We have a phenomenal team (ex-Qualtrics, Stanford Healthcare, Intermountain, Team Select, etc.) and an exceptional investor group of healthcare-focused VCs and former and current CEOs of top public healthcare companies.

About the Role

The Authorizations & Transitions Specialist plays a critical role in ensuring patients are successfully activated into care by managing partner authorizations, and care transitions between agencies.

This role combines healthcare operations, partner coordination, and patient-facing communication. In addition to processing eligibility and respite authorizations, this role owns the end-to-end transition process when patients move between Home Care Agencies, ensuring minimal disruption to care and a smooth experience for patients and families.

The specialist works closely with partners, patients/caregivers, and internal teams to coordinate referrals, confirm agency acceptance, and maintain accurate system documentation.

Schedule

9am-5pm (standard in their time zone)

Key Responsibilities

Authorization Management

Eligibility Letter Processing (Daily & Bi-Weekly Reviews)

• Conduct daily review of Alignment Results report

• Send GUIDE Beneficiary Alignment Letters to POA/Patient

• Retrieve Athena Patient ID and caregiver/POA contact information

• Maintain accurate tracking of status and follow up on missing information

Respite Authorization Processing (Partner-Facing)

• Confirm Home Care Agency partner

• Validate or update referring provider information (Athena / HubSpot)

• Send Respite Authorization Letters to Home Care Agencies

• Escalate missing or incomplete partner contact information as needed

Care Transitions Management

Transition Coordination & Ownership

• Own the end-to-end transition process when patients move from one Home Care Agency to another

• Review active and available agencies within the patient’s geographic area

Partner Outreach & Referral Placement

• Conduct outreach to eligible Home Care Agencies to identify availability and fit

• Facilitate referral placement by:

  • Sharing patient details appropriately

  • Confirming agency acceptance of referral

• Ensure timely follow-up with agencies to avoid delays in care transitions

Patient & Caregiver Communication

• Communicate with patients, caregivers, and/or POAs regarding:

  • Transition rationale

  • Next steps

  • New agency details

• Ensure a smooth and supportive experience during transitions, minimizing confusion or disruption

Operational Maintenance

• Support ongoing operational projects, including:

  • Data cleanup and system accuracy initiatives

  • Ongoing eligibility verification

  • Accurate agency assignment

Documentation & System Updates

• Accurately document all transition-related activity in internal systems (Athena, HubSpot, trackers)

• Update care team information to reflect new agency placement

• Maintain clear notes on outreach attempts, agency responses, and transition status

Escalation & Issue Resolution

• Identify and escalate risks impacting successful transitions, including:

  • Lack of agency availability

  • Delayed partner responses

  • Patient or caregiver concerns

• Partner with internal teams to resolve blockers and ensure continuity of care

Minimum Qualifications

Experience

• 1-3+ years of experience in healthcare operations, care coordination, intake, or similar roles

• Associates Degree is a plus

• Experience working with referrals, authorizations, or eligibility workflows

• Experience coordinating across partners, providers, or care teams

• Experience in home health, telehealth, or care coordination environments preferred

Systems & Tools

• Experience using EMR systems (Athena preferred)

• Familiarity with CRM tools (HubSpot or similar)

• Comfortable managing workflows across multiple systems and trackers

Core Skills & Attributes

• Operational Ownership & Follow-Through:
  Takes full ownership of authorization, and transition workflows, ensuring patients move efficiently from intake to care without delays.

• Coordination Across Stakeholders:
  Effectively manages communication between patients, caregivers, Home Care Agencies, and internal teams to ensure smooth transitions and continuity of care.

• Attention to Detail & Accuracy:
  Maintains high standards for documentation, authorization processing, and system updates to ensure compliance and prevent downstream issues.

• Process Discipline & Workflow Management:
  Follows structured workflows while managing multiple cases simultaneously, ensuring SLAs and timelines are consistently met.

• Problem-Solving in Dynamic Situations:
  Navigates ambiguity such as limited partner availability or incomplete information, identifying solutions to move patients forward.

• Persistence & Partner Outreach Skills:
  Demonstrates proactive follow-up and persistence when coordinating with partners to secure timely referral acceptance and placement.

• Analytical Thinking & Prioritization:
  Evaluates case urgency, partner availability, and patient needs to prioritize actions and optimize time to placement.

• Patient-Centered Communication:
  Communicates clearly and empathetically with patients and caregivers during transitions, ensuring understanding and minimizing disruption.

• Adaptability & Flexibility:
  Comfortable managing both structured processes (authorizations) and variable workflows (transitions) in a fast-paced environment.

• Systems Proficiency:
  Able to work across EMR, CRM, and tracking tools to maintain accurate visibility into case status and progression.

Benefits

We feel it is essential to invest in benefits that enable our employees to live healthy and full lives, including:

• Opportunity for professional development and career growth

• Ability to work from the comfort and convenience of your home. We are a fully remote company.

• Generous PTO

• Highly competitive health, vision, and dental insurance coverage for a startup at our stage.