Healthcare Ops Leader: Access & Authorization

PM Consulting; Philippines; On-site; PHP 1,500,000 - 2,600,000; Full time

Job summary

PM Consulting seeks a Healthcare Operations Manager – Patient Access & Authorization to lead high‑volume payer pre‑certification, verification, and authorization workflows across the organization.

You will develop KPIs, oversee supervisors and teams, align with clinical and revenue cycle groups, and drive new program implementation and scalable processes in a fast‑growing environment.

Qualifications

• Bachelor’s degree in Healthcare Management, Business Administration, Nursing, Allied Health, or related field.
• Minimum of 5–7 years of experience in healthcare operations, patient access, prior authorization, pre-certification, insurance verification, revenue cycle, or related environment.
• Minimum of 3 years in people management or leadership, preferably supervising multiple teams.
• Strong experience managing high-volume healthcare operations and performance-driven teams.
• Experience with new program implementation, start-up operations, transition, or optimization is highly preferred.

Responsibilities

• Provide overall operational leadership for Patient Access and Benefits & Authorization functions, ensuring efficient and timely completion of high-volume workflows.
• Manage and develop Supervisors and Team Leads, setting performance expectations and accountability.
• Oversee authorization and pre-certification operations for orthopedic services and related procedures.
• Establish and monitor KPIs including productivity, turnaround time, quality, and denial rates.
• Coordinate with clinicians, scheduling, revenue cycle, and payers to minimize delays and improve patient access.
• Develop standardized workflows, SOPs, and training materials.
• Lead continuous improvement initiatives focused on process efficiency and quality.
• Provide escalation support for complex authorization issues and payer disputes.
• Ensure compliance with payer requirements, CPT/ICD-10, and regulatory standards.
• Lead workforce planning, staffing models, and performance management.

Skills

Healthcare Operations Leadership

Patient Access & Authorization

People & Leadership Development

Data Analysis & Reporting

Quality & Compliance

Project Management

Strategic Planning

Education

Bachelor’s degree in Healthcare Management or related field

Advanced degree preferred

Tools

EHR systems

Payer portals

Microsoft Office

Job description

PM Consulting seeks a Healthcare Operations Manager – Patient Access & Authorization to lead high‑volume payer pre‑certification, verification, and authorization workflows across the organization.

You will develop KPIs, oversee supervisors and teams, align with clinical and revenue cycle groups, and drive new program implementation and scalable processes in a fast‑growing environment.