Authorizations & Transitions Specialist

PocketRN

Company Overview

PocketRN is the first telehealth company 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 are a fully remote team of clinicians and operators, backed by an exceptional group of healthcare-focused VCs and current and former CEOs of top public healthcare companies.

Position Summary

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.

Essential Functions & Key Responsibilities

The essential functions of this position include, but are not limited to:

• Conduct daily reviews of the Alignment Results report to track and verify beneficiary status.

• Retrieve Athena Patient IDs along with caregiver and Power of Attorney (POA) contact information to issue GUIDE Beneficiary Alignment Letters to patients and POAs.

• Issue and manage Respite Authorization Letters delivered to external Home Care Agencies to approve and activate program benefits.

• Oversee and manage the complete care transition process when patients transfer between Home Care Agencies.

• Conduct targeted outreach to eligible Home Care Agencies, facilitate referral placements, and align care resources.

• Maintain clear, proactive communication with patients, family caregivers, POAs, and agency partners throughout the entire transition lifecycle to minimize care disruptions.

• Accurately document all authorization, alignment, and transition activities across internal platforms, including Athena EMR, HubSpot, and operational tracking dashboards.

• Update care team assignments, contact details, and record status in real time while participating in ongoing database cleanup initiatives.

• Identify potential operational risks and care bottlenecks, such as agency capacity shortages or delayed partner responses.

• Escalate issues promptly and collaborate with internal operational, clinical, and partner management teams to clear obstacles and complete timely transitions.

Non-Essential / Marginal Functions

• Provide feedback on transition tools, tracking templates, and database workflows to enhance operational efficiency.

• Assist in drafting or updating job aids, standard operating procedures, and letter templates used for authorizations and transitions.

• Assist with ad-hoc reporting, administrative data audits, or seasonal program initiatives as assigned by leadership.

Physical Requirements 

• Must be able to remain in a stationary position for extended periods (up to 75–80% of the workday) while reviewing alignment reports, tracking agency transitions, conducting partner outreach, and updating electronic records on a computer.

• Constantly operates a computer keyboard, mouse, dual monitors, phone system, headset, and specialized software applications (Athena EMR, HubSpot, spreadsheet trackers) to process authorizations and manage transition workflows.

• Precise visual capability (close vision) required to inspect alignment reports, verify patient demographic and POA data, review complex medical records, and input high-volume alphanumeric information accurately.

• Frequently communicates via phone calls, email, video conferencing, and secure messaging with home care agency representatives, caregivers, POAs, patients, and internal clinical/operations teams. Must be able to clearly and accurately exchange detailed authorization and placement information.

• Needs to occasionally shift positions or step away from the workstation between processing alignment queues, conducting agency outreach calls, and completing system documentation.

• Minimal physical effort; occasionally required to adjust office equipment, position headsets, or manage home office supplies weighing up to 10–15 pounds.

• Functions in a remote, or standard climate-controlled indoor office environment with low to moderate noise levels; requires a private, quiet, and secure HIPAA-compliant workspace with a high-speed internet connection to handle sensitive patient records, legal power of attorney documents, and protected health information (PHI).

Additional Duties

• Employees may be assigned additional duties consistent with the position and the company's business needs.

• Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of the role.

Work Schedule & Work Environment

Schedule: Full-Time, Monday-Friday, 9:00 AM - 5:00 PM  in applicable standard time zone. Additional flexibility may be considered based on business needs, team requirements, and subject to leadership approval.

Work Location: This position is fully remote and may be performed only from Company-approved work locations, subject to applicable federal, state, and local requirements.

FLSA / Overtime

This position is classified as exempt from overtime requirements under applicable federal, state, and local law, subject to applicable legal requirements. The position may require work beyond standard business hours based on business and operational needs.

Required Qualifications

Education

• High School Diploma, GED, or equivalent education background.

• An Associates degree is a plus. 

Experience

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

• Experience working with referrals, authorizations, or eligibility workflows across care teams, partners, or providers.

Knowledge & Skills

• Strong operational ownership, process discipline, workflow management, and analytical thinking.

• Proficiency with EMR systems (Athena preferred), CRM tools (HubSpot or similar), and spreadsheet trackers.

• Patient-centered communication skills with empathy, persistence, and effective stakeholder coordination.

Licensure/Certification

• N/A

Preferred Qualifications

• Associate’s Degree.

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

• Experience using Athena EMR and HubSpot CRM systems.

Core Competencies

• Cross-Functional Collaboration

• Patient Experience & Service Excellence:

• Operational Ownership & Follow-Through

• Process Discipline & Workflow Management

Physical & Functional Requirements

The physical demands described below are representative of those that must be met to successfully perform the essential functions of this position.

This is a fully remote, virtual position. The employee must be able to perform extended periods of computer-based work and regularly participate in video and audio calls. The position requires a suitable home work environment and reliable internet access to support virtual meetings, orientation sessions, and other job-related activities.

Reasonable accommodations may be available for qualified individuals with disabilities in accordance with applicable law. Please see the Reasonable Accommodation section of this job description for additional information.

Compensation & Benefits

Where applicable based on role, employment status, and eligibility, employees may have access to benefits including:

• Paid time off, holidays, and parental leave

• 401(k)

• Medical, dental, and vision insurance

• Annual Keep Learning (education) stipend for professional development

• Other applicable benefits

Equal Employment Opportunity

PocketRN is committed to providing equal employment opportunities to all qualified individuals. We do not discriminate in employment or hiring practices based on race, color, national origin, religion, sex, pregnancy, gender identity or expression, sexual orientation, disability, age, genetic information, veteran status, or any other status protected by applicable federal, state, or local law.

Reasonable Accommodation

PocketRN is committed to providing reasonable accommodations to qualified individuals with disabilities in accordance with the Americans with Disabilities Act (ADA) and applicable federal, state, and local laws.

Examples of potential accommodations may include, as appropriate, modifications to work processes or schedules, assistive technology, accessible communication methods, or other reasonable modifications. Accommodation requests will be evaluated on an individualized basis in accordance with applicable law.

Disclaimer

This job description is intended to describe the general nature and level of work performed in this position. It is not intended to be an exhaustive list of all duties, responsibilities, qualifications, or requirements. Job duties, responsibilities, and requirements may be modified as business needs change, consistent with applicable law.

Nothing in this job description creates a contract of employment or alters the at-will employment relationship, where applicable.