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 Job!