Clinical Product Owner (Prior Authorizations SME)
Elite Technical is seeking a clinical focused Product Owner / Business Integration Lead with strong Healthcare integration experience to drive complex, cross functional initiatives. We are seeking a SME in Clinical Prior Authorizations, 278, & FACETS to support a complete analysis and possible re-design of our clients prior authorization process. Day to day responsibilities will be meeting with clinical, business and IT stakeholders to analyze the current prior authorization process, identify pain points, and drive resolutions to improve the prior authorization process.
This position is set to go until the end of 2026 with possible carry-on work into Q1/2027. This position is completely remote but EST hours must be worked.
Required Skills
-15+ years in healthcare delivery, payer operations, UM, or PA programs with the last 8+ years as a Clinical Product Manager
-Must have knowledge in: Clinical Prior Authorizations (end to end process), FACETS, Claims Processing, 278, and basic working knowledge of GuidingCare.
- End to end knowledge of clinical prior authorization is critically important to the success of this position
-Excellent communication, stakeholder management, and executive level reporting skills
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This position is set to go until the end of 2026 with possible carry-on work into Q1/2027. This position is completely remote but EST hours must be worked.
Required Skills
-15+ years in healthcare delivery, payer operations, UM, or PA programs with the last 8+ years as a Clinical Product Manager
-Must have knowledge in: Clinical Prior Authorizations (end to end process), FACETS, Claims Processing, 278, and basic working knowledge of GuidingCare.
- End to end knowledge of clinical prior authorization is critically important to the success of this position
-Excellent communication, stakeholder management, and executive level reporting skills
Apply tot his job
Apply To this Job