Manager Delivery- Clinical Prior Authorization

Description

The Manager Delivery - Clinical Prior Authorization will lead the clinical prior authorization team, ensuring high-quality service delivery and compliance with healthcare regulations. This role involves managing workflows, improving processes, and collaborating with various stakeholders to facilitate timely patient care.

Responsibilities

• Oversee the clinical prior authorization process to ensure timely and accurate approvals.
• Lead a team of clinical professionals to enhance the efficiency of the prior authorization workflow.
• Collaborate with healthcare providers, insurance companies, and internal stakeholders to resolve authorization issues.
• Monitor performance metrics and implement process improvements to optimize delivery.
• Train and mentor team members on best practices and compliance in clinical prior authorization.
• Ensure adherence to regulatory standards and company policies in all prior authorization activities.

Skills and Qualifications

Education

Master OF Business Administration (M.B.A), Bachelor of Liberal Arts (BLA / ALB), Master of Liberal Arts (MLA / ALM), Bachelor of Music Education (B.M.E.), Master of Health Administration (MHA), Bachelor of Education (B.Ed), Bachelor in Hotel Management (B.H.M), Bachelor of Dental Surgery (B.D.S), Master in Computer Application (M.C.A), Bachelor in General Studies (BGS), Bachelor of Health Science, Doctor of Audiology (AuD), Doctor of Ministry, Doctor of Public Health (DrPH), Master of Public Administration (MPA), Bachelor of Interdisciplinary Studies, Master of Accounting, Doctor of Dental Surgery / Medicine (DDS / DMD), Masters in Arts (M.A), Doctor of Nursing Practice (DNP), Bachelor of Arts (B.A), Master of Music (MM / MMus), Master of Professional Accountancy (MPA), Doctor of Veterinary Medicine (DVM), Master of Divinity, Master of Social Work (M.S.W), Bachelor of Applied Science (BAS), Doctor of Business Administration (DBA), Bachelor of Commerce (B.Com), Master of Fine Arts (MFA), Master of Tax Accounting, Master of Public Health (MPH), Master of Library & Information Science (MLIS), Masters in Technology (M.Tech / M.E), Doctor of Pharmacy (PharmD), Bachelor of Science (B.Sc), Master of Technical & Professional Communication, Master of Law (M.L / L.L.M), Bachelor Of Pharmacy (B.Pharm), MBBS, Master of Health Science (MHSc), Doctor of Education, Bachelor Of Technology (B.Tech / B.E), Doctor of Physical Therapy, Bachelor of Ayurvedic Medicine and Surgery (BAMS), Doctor of Jurisprudence, Doctor of Psychology (Psy. D. / D. Psych.), Doctor of Science (DSc / ScD), Master of Pharmacy (M.Pharm), Bachelor of Architecture (B.Arch), Bachelor of Homeopathic Medicine and Surgery (BHMS), Master of Library Science, Bachelors of Law (B.L / L.L.B), Bachelor Of Computer Application (B.C.A), Master of Education (M.Ed), Masters in Communications Disorders (MCD), Doctor of Musical Arts (DMA), Master of Real Estate Development, Master of Natural Resources (MNR), Doctor of Medicine (M.D / M.S), Doctor of Optometry, Master of Planning (M.Plan), Doctor of Chiropractic (DC), Master of Commerce (M.Com), Bachelor of Business Administration (B.B.A), Bachelor of Social Work (B.S.W), Bachelor of Music, Masters of Architecture (M.Arch), Master in Landscape Architecture

Skills Required

prior authorization , Project Management, Data Analysis, Team Leadership, Regulatory Compliance, Risk Management, Stakeholder Engagement, Process Improvement, performance metrics