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Prior Authorization List Business Owner

Remote, USA Full-time Posted 2025-11-03
**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!  

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