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!