Prior Authorization Manager

This is a fully remote position, open to applicants in United States.

📋 Description

• Oversee the daily operations of the Prior Authorization team.

• Guide, mentor, and develop Prior Authorization Specialists.

• Provide performance evaluations, mentorship, and hold team members accountable.

• Design and implement onboarding and training programs.

• Track productivity, turnaround times, and essential performance metrics.

• Create, implement, and enhance authorization workflows.

• Establish and maintain departmental policies, procedures, and process documentation.

• Introduce reporting tools and dashboards.

• Conduct quality audits to ensure accuracy, consistency, and compliance.

• Stay updated on payer policies and share updates and best practices.

• Manage complex authorization requests and address escalated payer issues.

• Ensure precise documentation of patient eligibility, benefits, and authorization activities.

• Conduct root cause analyses for recurring operational issues.

• Ensure compliance with payer requirements, regulatory standards, and internal quality expectations.

• Collaborate with Clinical, Intake, Billing, Operations, and Center Leadership teams.

• Act as the primary escalation point for queries and issues related to payers.

• Lead cross-functional projects aimed at enhancing patient and family experience as well as operational success.

⛳️ Requirements

• Over 5 years of experience in obtaining prior authorizations for ABA therapy.

• At least 2 years of experience in a leadership or management role.

• Solid understanding of insurance authorization processes and payer requirements.

• Excellent organizational and project management capabilities.

• Outstanding written and verbal communication skills.

• Demonstrated ability to tackle complex problems and enhance operational workflows.

• Experience in coaching, mentoring, and developing high-performing teams.

• Proficient in Microsoft Office or Google Workspace.

• Familiarity with prior authorization management platforms is preferred.

🏝️ Benefits

• Competitive base salary.

• Performance-based salary increases twice a year.

• Comprehensive medical, dental, and vision insurance.

• 401(k) plan with employer matching.

• Life insurance fully covered by the employer.

• Short-term disability insurance.

• 26 days of paid time off each year.

• Four weeks of paid parental leave.

• Relocation assistance available.

• Clear career advancement pathways and leadership development opportunities.