Associate Director, Prior Authorization Operations

Arizona Priority Care; Chandler (AZ); Hybrid; USD 100,000 - 110,000; Full time

Job summary

Arizona Priority Care, based in Chandler, Arizona, seeks an Associate Director of Prior Authorization. This role provides department-wide leadership for Medicare Advantage preservice operations, reporting to the Director of Clinical Services Operations.

The Associate Director oversees governance, performance, audits, and workforce strategy, while PA Coordinators remain under the PA Supervisor. The role requires five+ years in UM and three+ years of management in healthcare or payer settings,

Qualifications

• Five+ years of Utilization Management experience with Medicare Advantage preservice operations.
• Three+ years of management or supervisory experience in healthcare or payer environments.
• Bachelor’s degree in nursing, healthcare administration, business, or related field preferred; equivalent experience may be considered.
• RN license preferred but not required.

Responsibilities

• Provide department-wide accountability through the PA Supervisor and designated clinical leads; ensure coordinated Prior Authorization operations.
• Translate strategic direction into department priorities, performance expectations, governance standards, and measurable outcomes.
• Establish workforce strategy, capacity models, productivity standards, and resource recommendations; manage scheduling and workload.
• Lead leadership meetings; mentor PA Supervisor and clinical leads; set expectations for onboarding, coaching, and training.
• Maintain audit readiness; oversee CMS and NCQA compliance; review trend reporting and corrective actions.
• Oversee governance of SOPs, workflows, and performance controls; delegate maintenance to the PA Supervisor.
• Lead semiannual underutilization review activities and UM program reporting.
• Represent department with Medical Directors, health plans, and providers; communicate risks and recommendations.

Skills

Utilization Management

Medicare Advantage

Leadership

Regulatory compliance

CMS NCQA knowledge

Problem solving

Communication

Microsoft Office

EHR systems

Education

Bachelor’s degree in nursing, healthcare administration, business, or related field

RN license (preferred)

Tools

Microsoft Office

Electronic Health Record (EHR) systems

Job description

Arizona Priority Care, based in Chandler, Arizona, seeks an Associate Director of Prior Authorization. This role provides department-wide leadership for Medicare Advantage preservice operations, reporting to the Director of Clinical Services Operations.

The Associate Director oversees governance, performance, audits, and workforce strategy, while PA Coordinators remain under the PA Supervisor. The role requires five+ years in UM and three+ years of management in healthcare or payer settings,