Authorization Manager

Authorization Manager

This leadership role oversees the end-to-end prior authorization function within a high-volume healthcare operations environment, ensuring timely, accurate, and compliant processing across multiple clinical and administrative settings. You will lead supervisors, leads, and specialists while driving operational excellence across turnaround time, accuracy, productivity, and payer compliance. The role requires strong analytical and process leadership skills to optimize workflows, reduce denials, and improve patient access to care. You will collaborate closely with scheduling, billing, clinical operations, compliance, and payer relations teams to ensure alignment across the revenue cycle. In this position, you will also monitor payer policy changes and industry trends to proactively adjust processes and mitigate risk. This is a highly impactful operational leadership role focused on efficiency, quality, and continuous improvement in a fast-paced healthcare environment.

Accountabilities:

• Provide leadership and oversight to the Authorization department, managing supervisors, leads, and specialists to ensure high performance and accountability.
• Define departmental KPIs, operational goals, and service standards to drive accuracy, speed, and productivity across authorization workflows.
• Oversee daily operations for standard, urgent, and retro authorization requests, ensuring timely and compliant processing.
• Develop, refine, and optimize workflows, SOPs, training materials, and escalation pathways to improve efficiency and consistency.
• Monitor payer policy updates, regulatory changes, and denial trends to ensure compliance and reduce downstream claim issues.
• Analyze performance data and operational metrics to identify risks, inefficiencies, and opportunities for improvement.
• Collaborate cross-functionally with billing, scheduling, clinical operations, compliance, and payer relations teams to align processes and improve outcomes.
• Lead workforce planning, staffing strategies, training programs, and succession planning to support departmental scalability.
• Oversee quality audits and corrective action plans to ensure continuous improvement and adherence to standards.
• Manage escalated issues from payers or clinics and ensure timely resolution with strong service orientation.

Requirements:

• Bachelor's degree in Healthcare Administration, Business, or related field preferred, or equivalent experience.
• 5+ years of experience in authorizations, insurance verification, medical billing, or revenue cycle operations.
• 2–3+ years of supervisory or management experience in a healthcare or revenue cycle environment.
• Strong knowledge of insurance authorization processes, payer guidelines, medical necessity rules, ICD-10, and CPT coding.
• Proven ability to lead teams, drive performance improvements, and manage high-volume operational environments.
• Strong analytical, problem-solving, and decision-making skills with a data-driven mindset.
• Excellent communication and collaboration skills with the ability to influence cross-functional stakeholders.
• Proficiency in Microsoft Office tools and experience with EMR systems, payer portals, and reporting tools.
• Strong organizational skills with the ability to manage multiple priorities and maintain operational control.
• High level of professionalism, discretion, and commitment to operational excellence.

Benefits:

• Competitive annual salary ranging from $52,000 to $72,000, depending on experience and qualifications.
• Opportunity to lead a critical healthcare operations function with direct impact on patient access and revenue cycle performance.
• Comprehensive professional development and mentorship opportunities within a mission-driven organization.
• Exposure to industry-leading training programs and evidence-based operational practices.
• Collaborative and supportive work environment focused on continuous improvement and team development.
• Opportunity to contribute to process innovation, workflow optimization, and large-scale operational initiatives.
• Inclusive workplace culture committed to expanding access to quality care.
• Standard benefits may include healthcare coverage, paid time off, and retirement savings options (varies by eligibility).