Job Description:Role Summary:The Manager, Authorizations will be responsible for managing the daily prior authorization operations. This role oversees the collaboration between all RCM authorization team members, authorization vendor partners, practice staff and operational leadership to obtain authorizations for patient services in a timely and accurate fashion. The position is responsible for creating sustainable workflows and communicating effectively to protect the financial health of the practice and reduce revenue leakage.
Primary Responsibilities:- Complete management of the prior authorization team
- Hire new team members as necessary and manage the performance of all existing team members
- Create and maintain a staffing model that adequately meets the demand for prior authorizations within the practice
- Set expectations on service delivery for vendor partners responsible for obtaining prior authorizations for patient services
- Develop and maintain standard workflows for obtaining prior authorizations
- Manage prior authorizations denials and escalations to ensure patients can be treated in a timely fashion
- Communicate effectively with practice staff and operational leadership to reduce revenue leakage during the prior authorization process
Training & Education- Design and implement a comprehensive training program for all prior authorization team members and vendor partners
- Deliver hands-on training for new workflows and system updates
- Establish onboarding programs for new hires
Cross-Functional Alignment- Ensure alignment between clinical and prior authorization workflows
- Partner with the AR team to perform a root cause analysis on all denials to reduce gaps in the process and provide retraining to team members.
Additional responsibilities as assigned to help drive our mission of improving the lives of everyone living with cancer.
Required Qualifications:- Bachelor's degree or equivalent experience
- 5+ of experience in RCM operations
- 2+ years in leading teams
- Deep understanding of the prior authorization process and payer medical necessity guidelines
- Proven experience leading global teams and vendor partners
- Strong working knowledge of healthcare compliance
- Experience designing and delivering role-based training programs for staff, including onboarding, workflow changes, and system updates
- Ability to define, track, and interpret operational and revenue cycle metrics (e.g., charge lag, denials, documentation accuracy), conduct root-cause analysis, and drive corrective actions
- Experience with workflow optimization, system implementation, and training delivery
- Experience working cross-functionally with clinical, operational, and RCM teams
Essential Competencies:- Attendance is an essential job function.
- Ability to lead end-to-end workflow design, system implementation, and stabilization efforts, identifying inefficiencies and managing change
- Ability to establish governance standards and ensure alignment between clinical and revenue cycle stakeholders
- Ability to design, deliver, and sustain role-based training programs tailored to clinical and operational audiences
- Skilled in analyzing performance metrics, conducting audits, leading root cause analysis, and driving corrective actions
- Demonstrated continuous improvement mindset, with experience scaling best practices across sites or markets
- Proven ability to drive operational performance and revenue improvement
- Strong collaboration, verbal, and written communication skills
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