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