Prior Authorization List Business Owner
**Overview:**
We are seeking a seasoned professional to join our team as a Prior Authorization List Business Owner. As a key member of our organization, you will be responsible for overseeing the Medicare and Medicaid prior authorization process, collaborating with internal stakeholders, and maintaining prior authorization lists. **Responsibilities:**
Ā Ensure compliance with regulatory requirements
Ā Lead a Prior Authorization List governance committee and other meetings
Ā Maintain the PAL on external and internal sites, including the twice-a-year provider mailer
Ā Serve as a subject matter expert, staying up-to-date on market and Medicaid state changes to drive continuous improvement
Ā *Qualifications:**
Ā Bachelor's degree
Ā 5 or more years of experience in insurance or healthcare setting
Ā Proficient with Microsoft Access, Excel, Word
Ā Excellent communication skills, both oral and written
Ā Experience implementing and measuring success on complex health-related initiatives and pilots
Ā Strategic thinker with ability to work independently
Ā Strong relationship building skills
Ā Strong analytical skills
Ā Process-focused, with ability to leverage and enhance existing processes
Ā Exercises independent judgment and decision making on complex issues
Ā *Benefits:**
Ā Competitive compensation package
Ā Medical, dental, and vision benefits
Ā 401(k) retirement savings plan
Ā Time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave)
Ā Short-term and long-term disability
Ā Life insurance
Ā And many other benefits to support whole-person well-being
Apply Now
We are seeking a seasoned professional to join our team as a Prior Authorization List Business Owner. As a key member of our organization, you will be responsible for overseeing the Medicare and Medicaid prior authorization process, collaborating with internal stakeholders, and maintaining prior authorization lists. **Responsibilities:**
Ā Ensure compliance with regulatory requirements
Ā Lead a Prior Authorization List governance committee and other meetings
Ā Maintain the PAL on external and internal sites, including the twice-a-year provider mailer
Ā Serve as a subject matter expert, staying up-to-date on market and Medicaid state changes to drive continuous improvement
Ā *Qualifications:**
Ā Bachelor's degree
Ā 5 or more years of experience in insurance or healthcare setting
Ā Proficient with Microsoft Access, Excel, Word
Ā Excellent communication skills, both oral and written
Ā Experience implementing and measuring success on complex health-related initiatives and pilots
Ā Strategic thinker with ability to work independently
Ā Strong relationship building skills
Ā Strong analytical skills
Ā Process-focused, with ability to leverage and enhance existing processes
Ā Exercises independent judgment and decision making on complex issues
Ā *Benefits:**
Ā Competitive compensation package
Ā Medical, dental, and vision benefits
Ā 401(k) retirement savings plan
Ā Time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave)
Ā Short-term and long-term disability
Ā Life insurance
Ā And many other benefits to support whole-person well-being
Apply Now