Source Job

US

  • Manage prior authorization workflows with vendors, providers, patients, and payors.
  • Develop processes and training materials for offshore teams to resolve authorization issues.
  • Own Prior Authorization outcomes and KPIs for your region or payors.

7 jobs similar to Prior Authorization Manager

Jobs ranked by similarity.

US Unlimited PTO

  • Provide expertise in prior authorization and implement the Inspire Prior Authorization Program.
  • Support patient intake, verify insurance, and manage prior authorization requests.
  • Train sites on program requirements and assist with appeals through External Medical Review.

Inspire Medical Systems is a medical device company dedicated to treating Obstructive Sleep Apnea with an innovative FDA-approved device. The company values a people-first culture, offering excellent benefits, 401k matching, and flexible time off, and is committed to diversity and patient outcomes.

US 16w PTO

  • Manage the full Authorization process, from initial notification to determination and discharge, with detailed documentation in EMR and payer systems.
  • Verify patient eligibility and benefits, act as a liaison between hospital staff and health payers, and track pending authorizations for timely responses.
  • Maintain HIPAA compliance, escalate issues causing delays or denials, and manage workloads through accurate record keeping.

CorroHealth is a partner to healthcare providers, solving revenue cycle challenges through a mix of services, consulting, and technology. The company focuses on scalability and clinical expertise, building long-term careers by investing in employee development.

US Unlimited PTO

  • Collaborate with a multidisciplinary team to manage referrals, prior authorizations, and medical records for whole-person member care.
  • Apply knowledge of CPT/ICD-10 codes and insurance requirements to obtain authorizations, appeals, and follow up for positive outcomes.
  • Assist members with accessing services, provide personalized customer service, and track data to refine operational processes.

Oshi Health is a virtual digestive health practice transforming GI care with compassionate, multidisciplinary care and innovative technology. It is a mission-driven, remote-first startup focused on personalized care plans and building a diverse team.

$128,000–$160,000/yr
US

  • Design and configure prior authorization criteria, decision trees, and authorization parameters within the PA system.
  • Perform quality assurance and quality control reviews to ensure clinical intent and regulatory compliance.
  • Collaborate with internal teams and external clients to support delegated PA services and system optimization.

Judi Health is an enterprise health technology company providing a comprehensive suite of solutions for employers and health plans. The company is a public benefit corporation focused on rebuilding trust in healthcare in the U.S., with a culture that emphasizes collaboration and client support.

US

  • Assists with patient medication management and facilitates medication renewal requests.
  • Acts as a liaison between providers, patients, and pharmacies for prescriptions and prior authorizations.
  • Monitors prior authorization status and updates relevant parties throughout the process.

Mass General Brigham is a not-for-profit integrated health care system supporting patient care, research, teaching, and community service. They employ a diverse team of professionals including doctors, nurses, and tech experts, fostering a collaborative culture focused on exceptional care.

United States

  • Conduct benefit investigations, insurance verification, and prior authorizations to secure timely patient access to therapies.
  • Manage patient case files, coordinate product ordering and shipment with pharmacies and prescribers.
  • Handle inbound inquiries, report adverse events, and educate stakeholders on program requirements.

Jobgether is a platform that uses AI-powered matching to connect candidates with hiring companies. They focus on efficient, objective candidate screening and share top-fitting shortlists with employers.

  • Manage front desk operations, patient scheduling, insurance verification, and prior authorizations.
  • Support medical billing by reviewing claims, posting payments, and following up on denials.
  • Maintain HIPAA compliance while handling patient records and administrative tasks.