Director, Authorization Management & Pre-Service

Sarasota Memorial Hospital; Louisville, Northern (KY, KY); Hybrid; USD 120,000 - 190,000; Full time

Job summary

Norton Healthcare is seeking a System Director Authorization Management & Pre-Service to lead a team of denial nurses, utilization review staff, and pre-service and insurance verification representatives. You will drive utilization review processes across prospective, concurrent, and retrospective reviews and coordinate with Payors and care management to secure timely authorizations.

Required: five years of management experience in care management or clinical settings and a Bachelor’s degree.

Qualifications

• Five (5) years of management experience in care management & care coordination setting and/or clinical experience.

Responsibilities

• Assists staff to ensure proper hospital and payor authorization requirements are met.
• Provides annual performance evaluations for direct reports and feedback to other system leaders as requested.
• Identifies and coordinates improvement opportunities to reduce insurance denials/loss of revenue.
• Responsible for achieving annual department performance metrics and managing financial resources to meet the budget.
• Leads and coaches the team to ensure high quality outcomes and exceptional patient care.

Education

Bachelor Degree

Master Degree

Job description

Norton Healthcare is seeking a System Director Authorization Management & Pre-Service to lead a team of denial nurses, utilization review staff, and pre-service and insurance verification representatives. You will drive utilization review processes across prospective, concurrent, and retrospective reviews and coordinate with Payors and care management to secure timely authorizations.

Required: five years of management experience in care management or clinical settings and a Bachelor’s degree.