Healthcare Operations Lead: Pre-Cert & Scheduling

Our Clients; Quezon City; Hybrid; PHP 800,000 - 1,300,000; Full time

Job summary

Our Clients is seeking a Healthcare Lead to oversee pre-certification, prior authorization, scheduling, and patient access functions. You will guide teams, ensure compliant processing, and minimize delays while supporting clinic readiness and accurate documentation.

Lead responsibilities include coaching, monitoring performance, handling escalations, and collaborating with clinical teams and payers to sustain efficient healthcare workflows.

Qualifications

• Bachelor’s degree in Healthcare Management, Business Administration, Nursing, or related field.
• 3–5 years of healthcare experience in pre-certification, prior authorization, scheduling, or related functions.
• At least 2 years of leadership, team lead, supervisory, or workflow coordination experience.
• Strong knowledge of insurance authorization, payer requirements, and healthcare workflows.
• Familiarity with CPT, ICD-10, medical terminology, EHR systems, payer portals, and authorization platforms.
• Strong communication, analytical, organizational, and problem-solving skills.
• Ability to manage high-volume workflows and multiple priorities in a fast-paced healthcare environment.

Responsibilities

• Oversee daily pre-certification, prior authorization, and scheduling workflows.
• Monitor team productivity, quality, turnaround times, accuracy, and service levels.
• Provide coaching, guidance, and performance support to team members.
• Handle escalated authorization, payer, scheduling, and patient access issues.
• Ensure accurate documentation of authorization and scheduling activities in EHR and related systems.
• Coordinate with clinical teams, providers, payers, and front-end staff to prevent delays and appointment cancellations.
• Ensure compliance with payer requirements, medical necessity guidelines, and organizational policies.
• Maintain and improve SOPs, workflows, and operational guidelines.
• Identify process gaps and implement improvements to reduce delays, rework, and denials.
• Support staffing, workload allocation, training, and team performance activities.
• Prepare operational reports and communicate performance updates and concerns to leadership.
• Support implementation, transition, and process improvement initiatives as needed.

Skills

Leadership

Communication

Analytical

Organizational

Problem-solving

Healthcare operations

Education

Bachelor’s degree in Healthcare Management, Business Administration, Nursing, or related field

Tools

EHR systems

Payer portals

Authorization platforms

Job description

Our Clients is seeking a Healthcare Lead to oversee pre-certification, prior authorization, scheduling, and patient access functions. You will guide teams, ensure compliant processing, and minimize delays while supporting clinic readiness and accurate documentation.

Lead responsibilities include coaching, monitoring performance, handling escalations, and collaborating with clinical teams and payers to sustain efficient healthcare workflows.