Drug Authorization Operations Lead

Dana-Farber Cancer Institute; Brookline (MA); Presencial; USD 64.000 - 71.000; Jornada completa

Descripción de la vacante

Dana-Farber Cancer Institute in Boston is seeking a Drug Authorization Specialist Supervisor to lead the drug and procedure prior authorization workflows for outpatient services. You will manage non-clinical staff, ensure adherence to payer policies, and coordinate with clinical leaders to secure timely approvals before service delivery.

Responsibilities include queue management, denial trend analysis, policy updates, and cross-department collaboration with Revenue Cycle, Access Management, and

Formación

• Bachelor's degree in Business, Finance, Healthcare or related field.
• 4 years of experience in patient access, prior authorization, revenue cycle, or health insurance operations required.
• Demonstrated experience with third-party payer medical coverage policies, work queues, and denial management required.
• 2 years of supervisory or team lead experience in a healthcare or revenue cycle setting preferred.

Responsabilidades

• Manages the daily operations and work queues for drug authorization staff to ensure timely approval of drug and procedural authorizations prior to service delivery.
• Monitors team throughput, queue volumes, and turnaround times; proactively reallocating staff resources to address urgent treatment plans or high-volume queues.
• Coordinates escalation workflows when clinical interventions are required, fostering communication between attending providers, clinical specialists, and payer representatives.
• Oversees drug auth workflows related to prior authorization denials, retro-authorizations, and administrative appeals; monitors denial trends and coordinates handling with revenue cycle teams.
• Regularly audits team workflows, tools, and spreadsheets to identify gaps and streamline processes; implements new templates and tools to improve efficiency.
• Participates in interdepartmental meetings to align workflows with Access Management, Billing, and Clinical Operations.

Conocimientos

Payer policies

Supervision

Leadership

EMR systems

MS Office

Communication

Prioritization

Revenue cycle

Educación

Bachelor's degree in Business, Finance, Healthcare or related field

Herramientas

EMR systems

Revenue cycle software

Microsoft Office

Descripción del empleo

Dana-Farber Cancer Institute in Boston is seeking a Drug Authorization Specialist Supervisor to lead the drug and procedure prior authorization workflows for outpatient services. You will manage non-clinical staff, ensure adherence to payer policies, and coordinate with clinical leaders to secure timely approvals before service delivery.

Responsibilities include queue management, denial trend analysis, policy updates, and cross-department collaboration with Revenue Cycle, Access Management, and