Manager, Patient Access Operations

MML US Inc; San Diego (CA); Hybrid; USD 90,000 - 115,000; Full time

Benefits offered by this job

Equity

Medical insurance

Dental insurance

Vision insurance

Job summary

Mainstay Medical seeks a Manager, Patient Access Operations in San Diego to lead the Prior Authorization, Benefit Verification, and Intake Coordinator teams. This hands-on leader coaches staff, aligns workflows with Case Managers and reimbursement partners, and drives accurate, timely patient access from intake to authorization.

The role demands strong leadership, payer knowledge, and a patient-centric approach, with remote candidates considered and a comprehensive compensation package including

Qualifications

• Bachelor’s degree and 5+ years related experience or advanced degree with relevant experience.
• Experience in patient access, prior authorization, reimbursement, utilization review, or related healthcare setting.
• Prior supervisory or team-lead experience preferred.
• Strong understanding of payer requirements, coverage criteria, and documentation standards.
• Experience with Medicare, Medicaid, Tricare, Workers’ Compensation and Commercial Insurance.
• Ability to coach others while balancing hands-on case/workflow responsibilities.

Responsibilities

• Provide day-to-day leadership, coaching, and performance management for the patient access team.
• Work with Case Managers and internal partners to prioritize workload and resolve barriers.
• Ensure consistent execution of workflows and processes.
• Serve as resource for payer requirements and authorization processes.
• Maintain direct responsibility for patient access activities as needed.
• Identify operational trends, improve efficiency, and reduce delays.
• Help build scalable processes to reduce denials and administrative burden.

Skills

Leadership

Prior authorization experience

Payer processes

Communication skills

Organizational skills

Problem solving

Cross-functional collaboration

Empathy patient-centric

Education

Bachelor’s degree

Experience in healthcare settings

Tools

Salesforce

Availity

eFax

Microsoft Office

Excel

PowerPoint

Job description

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process.

Manager, Patient Access Operations

Management San Diego, CA, US

Salary Range: $90,000.00 To $115,000.00 Annually

Location: Main office in San Diego, CA, with quarterly travel required. Remote candidates will be considered.

Mainstay Medical

Mainstay Medical is a medical device company focused on marketing an innovative implantable neurostimulation system, ReActiv8®, for people with disabling chronic mechanical Low Back Pain. The company is headquartered in Dublin, Ireland, with subsidiaries operating in Ireland, the United States, Australia, and Germany.

The Role:

The Manager, Patient Access Operations is a hands‑on people leader responsible for the day-to-day leadership, coaching, and performance of the Prior Authorization Specialist, Benefit Verification, and Intake Coordinator team, while remaining actively involved in patient access operations. This is a player/coach role: you will lead and develop the team and maintain direct responsibility for patient access activities and cases as needed, helping ensure patients move efficiently from initial intake through authorization with accuracy, urgency, and consistent follow-through.

Position Responsibilities:

• Provide day-to-day leadership, coaching, and performance management for the patient access team
• Work closely with Case Managers and internal reimbursement and market access partners to provide operational leadership, prioritize workload, resolve barriers, and support complex cases
• Ensure consistent execution of established workflows and processes
• Serve as a subject‑matter resource for payer requirements, prior authorization processes, and patient access operations
• Maintain direct responsibility for patient access activities and cases as needed
• Identify operational trends, improve efficiency, and reinforce accountability
• Help build scalable processes that reduce avoidable delays, preventable denials, and administrative burden on physician offices and field sales teams

Qualifications:

• Bachelor’s degree and 5+ years of related experience, or an advanced degree with relevant experience, or equivalent work experience
• Experience in patient access, prior authorization, reimbursement, utilization review, or a related healthcare setting (medical office, hospital, or payer environment)
• Prior supervisory, team lead, coaching, training, or other people‑leadership experience preferred
• Strong understanding of prior authorization requirements, payer processes, coverage criteria, documentation standards, and health insurance industry practices
• Experience with Medicare, Medicaid, Tricare, Workers’ Compensation, and Commercial Insurance
• Demonstrated ability to coach and develop others while balancing people leadership with hands‑on case and workflow responsibilities
• Strong problem‑solving skills, with the ability to identify solutions to operational challenges and process impediments
• Ability to collaborate across functions and appropriately elevate complex issues
• Superior oral and written communication skills, excellent organizational skills, and attention to detail
• Proficiency in Microsoft Office (Word, Outlook, Excel, PowerPoint) and experience with platforms such as Salesforce, Availity, eFax systems, and basic database management programs
• Caring, empathetic, and patient‑centric approach in all interactions

The salary range for this position is $90,000 to $115,000/year; however, base pay offered will take into account a range of factors, including job‑related knowledge, skills, and experience. The total compensation package includes a range of medical, dental, vision, financial, and other benefits, as well as equity.

Mainstay Medical is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to gender, race, color, religious creed, national origin, age, sexual orientation, gender identity, physical or mental disability, and/or protected veteran status. Mainstay Medical participates in E-Verify.