Prior Authorization Manager

Location

Anchorage, AK | United States

Job description

Title: Prior Authorization Manager

As a Prior Authorization Manager, you will be part of an innovative product company with a mission to serve the healthcare needs of our communities. You will oversee and guide your team to deliver superior service and achieve account goals and outcomes. You manage the performance and engagement of your staff and vendor resources, optimize processes, and maintain the highest quality standards. Your work directly supports the Account Delivery Manager [ADM], Regional Leader, and internal business partners in achieving or exceeding contractual obligations and company goals and objectives.

WHAT WE OFFER:

• The pay range for this position is $97,500 - $139,300 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors.
• Hybrid role with ability to work in the Anchorage, AK office preferred, with the possibility of working remotely from another state for the right candidate. The person will need to work Alaska Time hours.
• Flexible Vacation Policy
• Comprehensive Health Benefits
• 401k Employer Match
• Educational Assistance

WHAT YOU'LL DO:

• Build, develop, and lead teams of leaders and individual contributors, supporting employees and executing day-to-day operations delivery for an account(s).
• Establish and effectively lead routines regularly and utilize tools and reporting to drive team performance; train and provide ongoing coaching (account-specific metrics, AHT, APT, Occupancy, Utilization, Quality scores, etc.) to ensure employee engagement while maintaining client satisfaction.
• Effectively cultivate relationships with account leaders and business partners to proactively identify and enact opportunities to improve the delivery of operational products, services, and capabilities.
• Work with employees and operational leaders to achieve Client Service Level Agreements (SLAs) and drive accountability and efficiency by adopting standard operating procedures.
• Create conditions for success by removing obstacles and championing change to drive employee awareness and a connection to their work and contributions.
• Identify and manage existing and emerging risks from business activities and implement mitigation strategies to improve performance.

WHAT YOU'LL BRING:

• Active Registered Nurse license in the United States preferred.
• 7 or more years of people management experience in healthcare.
• Experience in quality assurance to support accurate utilization decisions based upon nationally recognized guidelines and McKesson Interqual Criteria.
• Minimum of two years' Medicaid experience in Prior Authorization/Utilization Review preferred.
• Proficient with Microsoft Office suite required and experience with software applications to manage contact center and back-office operations preferred.
• Strong written and oral communication and interpersonal skills to work effectively with team members, customers, and clients.

Demonstrated strategic initiative implementation and execution, specifically with operating policies and procedures and work process improvements in operations. Fortuna Business Management Consulting (Fortuna BMC) was founded in 2012 by practicing professionals with more than 50 combined years of experience. Our headquarters is in McClellan, California with offices in Los Angeles and New York, and satellite offices in Philippines and Israel. Fortuna BMC is an active member of multiple California service agreements, including CMAS, ITMSA (Tier 2), CalPERS SpringFed Pool, as well as multiple municipalities and large corporation vendor pools.

A drug and background screening is required for this position. 

Job tags

Salary

$97.5k - $139.3k