Prior Authorization Team Lead

uD83DuDC4B Meet knownwell, weight-inclusive healthcare for all. Join a dynamic company that is changing the way obesity care is delivered. We offer weight management, primary care, nutrition counseling, and health coaching. Our hybrid care model allows for both in-clinic and virtual care to bring support to patients where and when they need it. knownwell raised $25 million in strategic funding in October 2025, led by CVS Health Ventures and supported by investors including a16z Bio + Health, Flare Capital, MassMutual, and Intermountain Ventures. With $50M raised to date, we’re scaling fast and expanding access to evidence-based obesity care nationwide. We are seeking a hands-on, experienced Prior Authorization Team Lead to oversee prescription prior authorization operations. This role is for someone seasoned in PA workflows who can step in, assess quickly, and keep things moving without a long ramp. You will own day-to-day execution across internal teams and external partners, ensuring timely approvals that directly impact patient access to care. Experience with metabolic health medications, including GLP-1s, is highly valued. You Will:

• Lead and manage prescription prior authorization operations, setting clear expectations and holding the line on accuracy, turnaround times, and approvals.
• Own the end-to-end PA process across intake, submission, follow-up, appeals, and resolution.
• Serve as the primary operational contact for the BPO partner, overseeing productivity, quality, SLA adherence, and ongoing performance optimization.
• Act as the escalation point for complex or high-risk cases, including denials and urgent medication needs.
• Ensure consistent, compliant handling of payer requirements across commercial and government plans.
• Monitor queue volumes, aging, approval rates, and denial trends, adjusting workflows to prevent delays and backlogs.
• Coach team members through live cases and real scenarios, identifying gaps and raising performance quickly.
• Partner with clinical, pharmacy, and patient experience teams to keep patients informed and care moving.
• Track performance metrics and use them to drive concrete process improvements, not passive reporting.

You Have:

• Minimum 3 years of direct experience managing prescription prior authorizations in a healthcare setting.
• Demonstrated experience managing a BPO partner, including SLA management and performance oversight.
• Proven experience with complex medications; GLP-1 authorization experience is a strong plus.
• Prior people leadership experience with accountability for output and quality.
• Strong working knowledge of payer rules, documentation standards, and appeal processes.
• Comfortable operating in EHRs and PA platforms with minimal guidance.
• Able to prioritize, make decisions, and stabilize operations in a fast-moving environment.
• Start-up or high-growth healthcare experience preferred.

We offer a comprehensive benefits package (Medical, Dental, Vision, 401k match, PTO), competitive salary, and the opportunity to be part of a purpose-driven organization that is dedicated to making a positive impact on the lives of patients. If you are an ambitious and experienced clinician who is passionate about transforming healthcare and creating meaningful change, we invite you to apply and join our dynamic team. Pay & Perks: uD83DuDCBB Fully remote opportunity uD83EuDE7A Medical, dental, and vision insurance uD83DuDCC8 401K retirement plan with company match uD83CuDFDD️ Up to 20 days of PTO per year + company holidays uD83DuDC76 Up to 14 weeks of parental leave (12 for non-birthing parents) uD83CuDFE1 Annual work from home stipend for remote employees knownwell, Inc. provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training. Based on current size of the clinic and HIPAA regulation, providers cannot receive care in clinic and provider’s household members cannot receive primary care in the clinic. We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us. Apply tot his job Apply To this Job