Team Leader – Prior Authorization (Medications) | Southwoods, Binan

Ubiquity; Biñan; On-site; PHP 502,000 - 725,000; Full time

Job summary

Ubiquity seeks an experienced Team Leader to manage our Prior Authorization operations in Laguna. You will coach agents, ensure payer guideline adherence, and drive performance improvements while coordinating with operations leadership.

Responsibilities include training, performance reviews, reporting, and acting as a subject matter expert on prior authorization policies and workflows. Strong leadership and analytical skills are essential.

Qualifications

• Minimum 1+ year of recent experience in Prior Authorization (medications).
• At least 2 years of experience in Customer Support and Healthcare Operations.
• Minimum 2 years of experience in a supervisory or team lead role.
• Proven experience managing teams of 10+ members.
• Familiarity with prior authorization workflows, payer guidelines, and medication approval processes is highly preferred.
• Strong proficiency in PC-based systems, internet tools, and reporting applications.
• Excellent leadership, communication, and decision‑making skills.

Responsibilities

• Lead and manage a team of Prior Authorization agents to meet or exceed defined KPIs through regular coaching, mentoring, and performance feedback.
• Ensure agents are properly trained and updated on payer requirements, clinical guidelines, workflows, and system/process changes related to medication prior authorizations.
• Conduct regular performance reviews, business reviews, and one-on-one coaching sessions to drive continuous improvement.
• Provide floor support as a subject matter expert in prior authorization policies, payer rules, and medication approval workflows; handle escalations when necessary.
• Monitor and manage work queues to ensure timely submission and follow-up of prior authorization requests in coordination with operations leadership and support teams.
• Prepare and submit required operational reports, including KPI dashboards, performance scorecards, trend analysis, and case reviews.
• Participate in internal/external calibration sessions, client discussions, and operational alignment meetings.
• Support administrative tasks and other responsibilities as assigned by management.
• Act as a liaison between agents, management, and HR for escalations related to employee relations, benefits, and workplace concerns.
• Drive engagement initiatives such as team-building activities and performance-based incentive programs in alignment with company policies.
• Ensure strict adherence to company policies, compliance requirements, and quality standards in prior authorization processing.

Skills

Team leadership

Prior Authorization

Operational performance mgmt

Coaching & mentoring

Data reporting

Tools

Athenahealth (Athena)

CoverMyMeds

Job description

Our company is seeking experienced Team Leaders for our Prior Authorization operations team in our Southwoods, Binan, Laguna office. This role is ideal for someone with strong leadership capability, hands-on experience in healthcare prior authorization (especially medications), and a solid understanding of operational performance management.

The Team Leader will play a critical role in ensuring team performance, quality compliance, and efficient workflow execution while supporting continuous improvement in prior authorization processes.

Key Responsibilities

• Lead and manage a team of Prior Authorization agents to meet or exceed defined KPIs through regular coaching, mentoring, and performance feedback.

• Ensure agents are properly trained and updated on payer requirements, clinical guidelines, workflows, and system/process changes related to medication prior authorizations.

• Conduct regular performance reviews, business reviews, and one-on-one coaching sessions to drive continuous improvement.

• Provide floor support as a subject matter expert in prior authorization policies, payer rules, and medication approval workflows; handle escalations when necessary.

• Monitor and manage work queues to ensure timely submission and follow-up of prior authorization requests in coordination with operations leadership and support teams.

• Prepare and submit required operational reports, including but not limited to KPI dashboards, performance scorecards, trend analysis, and case reviews.

• Participate in internal/external calibration sessions, client discussions, and operational alignment meetings.

• Support administrative tasks and other responsibilities as assigned by management.

• Act as a liaison between agents, management, and HR for escalations related to employee relations, benefits, and workplace concerns.

• Drive engagement initiatives such as team-building activities and performance-based incentive programs in alignment with company policies.

• Ensure strict adherence to company policies, compliance requirements, and quality standards in prior authorization processing.

Requirements

• Minimum 1+ year of recent experience in Prior Authorization (medications) is required.

• At least 2 years of experience in Customer Support and Healthcare Operations

• Minimum 2 years of experience in a supervisory or team lead role.

• Proven experience managing teams of 10 or more members.

• Familiarity with prior authorization workflows, payer guidelines, and medication approval processes is highly preferred.

• Experience using Athenahealth (Athena) or CoverMyMeds is a strong advantage.

• Strong proficiency in PC-based systems, internet tools, and reporting applications.

• Ability to handle confidential and sensitive healthcare information in compliance with regulations.

• Strong analytical skills with the ability to prioritize tasks, manage workload effectively, and drive results.

• Excellent leadership, communication, and decision‑making skills.