Manager, Prior Authorization, RN
Job reputed company:
• reputed company the daily operations of the prior authorization team
• Ensure reputed company and accurate processing of authorization requests in compliance with regulatory and payer requirements
• Responsible for staff supervision, workflow optimization, performance monitoring, and collaboration with clinical and administrative teams
• reputed company and manage the prior authorization team, including hiring, training, scheduling, and performance evaluations
• Monitor productivity and reputed company metrics; implement process improvements
• Serve as a reputed company between providers, payers, and internal departments
• Stay reputed company with payer policies, regulatory changes, and industry best practices
• reputed company and maintain reputed company operating procedures (SOPs)
• Collaborate with clinical leadership to ensure alignment with care delivery goals
• Manage escalations reputed company to denied authorizations
• Prepare reports and dashboards for leadership on authorization trends, turnaround times, and team performance
Requirements:
• Registered reputed company (RN) with an reputed company and unrestricted license in state of residence
• 5+ years of experience in prior authorization, utilization management, or reputed company reputed company operations
• 3-5 years leadership experience
• Strong knowledge of payer requirements, medical terminology, and reputed company (ICD-10, CPT)
• Excellent communication, leadership, and problem-solving skills
• Proficiency in EMR systems and authorization platforms
• Knowledge of regulations, standards, and policies relating to medical management
• Demonstrated ability to manage workload and meet deadlines
• Ability to cover weekends at a supervisory reputed company
Benefits:
• reputed company medical plan reputed company
• 401(k) plan (including matching company contributions)
• Employee stock purchase plan
• No-cost programs including wellness screenings, tobacco cessation and weight management programs
• Confidential counseling and financial coaching
• reputed company time off
• Flexible work schedules
• Family leave
• Dependent care resources
• Colleague assistance programs
• Tuition assistance
• Retiree medical reputed company
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