Manager, Authorization Operations

CarepathRx transforms hospital pharmacy from a cost center into an active revenue generator through a powerful combination of technology, market-leading pharmacy services and wrap-around services.

Job Details:

The Manager, Authorization Operations is responsible for managing the workflow of the department by assigning tasks, supporting staff, monitoring results and reporting to senior management.

This people leader will provide strategic support to traditional and specialty authorization operations by identifying and analyzing opportunities for improved processes, billing and collections activities, denial and appeal management, and overall metric and service level agreement performance.

Responsibilities 

• Monitors the performance and compliance of reporting personnel and provides feedback via performance evaluations and disciplinary action when necessary. 

• Assist with the preparation and monitoring of the budget for areas of responsibility. 

• Monitors the performance and compliance of reporting personnel and provides feedback via performance evaluations and disciplinary action when necessary. 

• Recruits, hires, trains, and supervises in all aspects of the job responsibilities 

• Interact with partners to resolve questions or issues related to the authorization team. 

• Select, coaches, motivates and aides in the development of a fully qualified staff of managers, supervisors and personnel.

• Direct the staff in providing mentorship to peers and support personnel for each of the disciplines within the authorization department.

• Provides updates to the team regarding changes in internal processes. 

• Devising work schedules and implementing guidelines. 

• Serves as a role model of excellent customer service by responding constructively to the needs of the partners, management staff, and patients. Responds with courtesy and respect in a way that reflects a positive department image.

• Visibly demonstrates a commitment to process improvement by actively seeking and using customer feedback to improve services. Being an active participant in performance improvement.

• Conducts staff meetings and updates personnel on company updates. 

• Performs in accordance with system-wide competencies/behaviors. 

• Performs other duties as assigned. 

Skills & Abilities 

• Excellent written and verbal communication 

• Organizational expertise

• Ability to delegate 

• Detailed oriented 

• Effective decision-making 

• High emotional intelligence

• Adaptability

• Change management oriented

• Time management 

• Conflict resolution 

Requirements 

• High School graduate required. 

• Bachelor’s degree or equivalent experience required. 

• 3 years leadership experience in a professional environment or other health care environment preferred. 

• Computer skills and Microsoft office products experience required. 

• Documented expertise in Intake/Insurance/Authorization (acute, ambulatory, home health, pharmacy) experience preferred. 

• Self-motivated needing minimal direction in execution of implementation projects, and internal and external customer communication

CarepathRx provides equal employment opportunity to all qualified applicants regardless of race, color, religion, national origin, sex, sexual orientation, gender identity, age, disability, genetic information, or veteran status, or other legally protected classification in the state in which a person is seeking employment. Applicants encouraged to confidentially self-identify when applying. Local applicants encouraged to apply. Drug-free work environment. Must be eligible to work in this country.

CarepathRx provides equal employment opportunity to all qualified applicants regardless of race, color, religion, national origin, sex, sexual orientation, gender identity, age, disability, genetic information, or veteran status, or other legally protected classification in the state in which a person is seeking employment. Applicants encouraged to confidentially self-identify when applying. Local applicants are encouraged to apply. We maintain a drug-free work environment. Applicants must be eligible to work in this country.