Prior Authorization Manager
Job Description:
- Lead the daily operations of the Prior Authorization team
- Lead, coach, and develop Prior Authorization Specialists
- Provide performance feedback, mentorship, and accountability
- Create and deliver onboarding and training programs
- Monitor productivity, turnaround times, and key performance metrics
- Design, implement, and optimize authorization workflows
- Develop and maintain department policies, procedures, and process documentation
- Implement reporting tools and dashboards
- Conduct quality audits for accuracy, consistency, and compliance
- Monitor payer policies and communicate updates and best practices
- Oversee complex authorization requests and resolve escalated payer issues
- Ensure accurate documentation of patient eligibility, benefits, and authorization activity
- Lead root cause analyses for recurring operational challenges
- Maintain compliance with payer requirements, regulatory standards, and internal quality expectations
- Partner with Clinical, Intake, Billing, Operations, and Center Leadership teams
- Serve as the primary escalation point for payer-related questions and issues
- Lead cross-functional initiatives improving patient and family experience and operational success
Requirements:
- 5+ years of experience obtaining ABA therapy prior authorizations
- 2+ years of leadership or management experience
- Strong knowledge of insurance authorization processes and payer requirements
- Excellent organizational and project management skills
- Exceptional written and verbal communication abilities
- Proven ability to solve complex problems and improve operational workflows
- Experience coaching, mentoring, and developing high-performing teams
- Proficiency with Microsoft Office or Google Workspace
- Experience with prior authorization management platforms is preferred
Benefits:
- Competitive base salary
- Performance-based raises twice per year
- Medical, dental, and vision insurance
- 401(k) with employer match
- 100% employer-paid life insurance
- Short-term disability insurance
- 26 days of paid time off annually
- Four weeks of paid parental leave
- Relocation assistance available
- Clear career pathways and leadership development opportunities