Director of Authorization Strategy & Pre-Service Excellence

Norton Healthcare; Whitner (KY); On-site; USD 95,000 - 120,000; Full time

Job summary

Norton Healthcare is looking for a System Director of Authorization Management & Pre-Service in Whitner, Kentucky. This leader will manage a team responsible for utilization review and denial management, fostering high-quality patient care.

The ideal candidate will have significant management experience, a Bachelor Degree, and be a Registered Nurse. Strong skills in critical thinking and communication are essential for the role, along with the ability to mentor a diverse team.

Qualifications

• Five years of management experience in care management or clinical settings.
• Registered Nurse with proven clinical background.
• Experience in care coordination and denial management.

Responsibilities

• Lead and manage a team focused on utilization review and denial management.
• Provide performance evaluations and feedback to direct reports.
• Identify improvement opportunities to reduce insurance denials.
• Ensure compliance with hospital and payor authorization requirements.
• Track financial key performance indicators related to denials.

Skills

Management experience

Clinical experience

Knowledge of managed care contracts

Critical thinking

Problem solving skills

Communication techniques

Education

Bachelor Degree

Master Degree

Tools

InterQual Care Guidelines

Milliman Care Guidelines

Job description

Norton Healthcare is looking for a System Director of Authorization Management & Pre-Service in Whitner, Kentucky. This leader will manage a team responsible for utilization review and denial management, fostering high-quality patient care.

The ideal candidate will have significant management experience, a Bachelor Degree, and be a Registered Nurse. Strong skills in critical thinking and communication are essential for the role, along with the ability to mentor a diverse team.