Oncology Authorization Lead - Benefits & Eligibility

cardinalhealth

California (MO)

Hybrid

USD 77,000 - 98,000

Full time

14 days+

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Benefits offered by this job

Medical, dental and vision coverage

Paid time off

Health savings account (HSA)

401k savings plan

Access to wages before pay day with my

Flexible spending accounts (FSAs)

Disability coverage

Work-Life resources

Paid parental leave

Healthy lifestyle programs

Job summary

Navista, an oncology practice alliance, seeks a Supervisor, Benefits Eligibility and Authorization to lead the oncology authorization team within Cardinal Health's Revenue Cycle Management. You will supervise daily activities, coordinate workflows, and ensure timely authorization requests and financial clearance to accelerate patient care.

Collaborate with physicians, nursing, pharmacy, and financial counseling to resolve barriers, review denials, and monitor performance metrics.

Qualifications

Bachelor's degree preferred in Healthcare Administration, Business, Nursing, or related field.
Minimum five (5) years of healthcare prior authorization, financial clearance, patient access, or revenue cycle experience preferred.
Minimum two (2) years of leadership, supervisory, or team lead experience in a healthcare setting preferred.
Oncology, infusion, radiation oncology, specialty pharmacy, or multi-specialty authorization experience strongly preferred.
Extensive knowledge of medical oncology treatment regimens, radiation oncology services, imaging, genetic testing, surgical procedures, and specialty referrals.
Strong understanding of Medicare, Medicaid, commercial payer, HMO, IPA, and delegated authorization requirements.
Experience managing prior authorization workflows, referral management, medical necessity review, and payer compliance.
Proven ability to reduce authorization-related denials, treatment delays, and revenue risk through effective operational oversight.

Responsibilities

Supervise and coordinate the daily activities of the oncology authorization team to ensure timely completion of authorization requests and financial clearance activities.
Monitor work queues, assign priorities, and manage staff productivity to support timely patient treatment and service scheduling.
Oversee prior authorization, referral, and medical necessity processes for oncology services and related areas.
Review escalated cases, denied authorizations, urgent treatment requests, and payer issues to ensure timely resolution.
Ensure authorizations are obtained prior to service, tracked appropriately, and renewed or extended as needed.
Collaborate with physicians, advanced practice providers, nursing, pharmacy, scheduling, and financial counseling teams to resolve barriers.
Conduct daily huddles, staff coaching, and workflow reviews to drive accountability, quality, and service excellence.
Monitor authorization turnaround times, aging inventories, pending requests, and high-priority patient cases to meet performance goals.
Maintain expertise on payer policies, medical necessity requirements, and regulatory changes impacting oncology services.
Review authorization-related denials and implement corrective actions to reduce revenue leakage.