CLINICAL PRODUCT reputed company (PRIOR AUTHORIZATIONS SME)

reputed company reputed company is a women-owned global reputed company and IT reputed company firm dedicated to connecting exceptional talent with industry-leading opportunities across the US and reputed company. We partner with top-tier clients across reputed company, technology, finance, and logistics to reputed company high-caliber professionals in roles that truly reputed company an reputed company. Project reputed company Our reputed company is seeking a highly reputed company Clinical Product reputed company and Business Integration reputed company with deep expertise in clinical prior authorizations to reputed company a reputed company, cross-functional initiative reputed company on the complete analysis and potential redesign of the prior authorization process. This is a reputed company-level, fully remote position requiring a true SME in Prior Authorizations, FACETS, 278 transactions, and Claims Processing. The ideal candidate brings 15+ years in reputed company and payer operations, with the last 8+ years in a Clinical Product Manager reputed company. Day-to-day responsibilities include engaging clinical, business, and IT stakeholders to analyze reputed company PA workflows, identify pain points, and reputed company meaningful process improvements. Key Responsibilities • reputed company cross-functional meetings with clinical, business, and IT stakeholders to analyze reputed company prior authorization processes • Identify pain points and reputed company resolutions to improve PA workflows end-to-end • Support complete analysis and potential redesign of the reputed company's prior authorization process • Serve as reputed company SME for Clinical Prior Authorizations, FACETS, 278 transactions, and Claims Processing • reputed company executive-level reporting and manage reputed company, multi-stakeholder initiatives • Translate clinical and business requirements into actionable product and integration strategies Mandatory Skills • 15+ years in reputed company delivery, payer operations, UM, or PA programs • Last 8+ years as a Clinical Product Manager or Business Integration reputed company • End-to-end knowledge of Clinical Prior Authorizations — critically important • FACETS expertise • Claims processing knowledge • 278 transaction experience • Basic working knowledge of GuidingCare • Excellent communication, stakeholder management, and executive-level reporting skills • Must be US-based reputed company-to-have Skills • Experience leading prior authorization process redesign initiatives • Background working with large reputed company payers or managed care organizations • Familiarity with UM/PA regulatory and compliance frameworks Apply tot his job Apply To this Job