Oncology Prior Authorization Leader

Astera Cancer Care; Huntsville (AL); On-site; USD 90,000 - 120,000; Full time

Job summary

Clearview Cancer Institute is seeking a Senior Oncology Prior Authorization Manager to lead a team of specialists in obtaining timely approvals for hematology and oncology treatments. You will review clinical data, coordinate with insurers and providers, and drive process improvements to reduce denials and delays.

Ideal candidates have oncology PA leadership experience, strong analytics, and exceptional communication skills to collaborate with care teams.

Qualifications

• Bachelor’s degree in nursing, pharmacy, or healthcare administration
• Extensive knowledge of oncology treatments, clinical guidelines and payer policies
• Proven experience in prior authorization management, particularly within oncology
• Strong analytical and problem-solving skills to navigate complex patient cases and payer requirements
• Excellent communication and interpersonal skills to collaborate with diverse stakeholders

Responsibilities

• Oversee the process of obtaining prior authorization for hematology and oncology treatments from insurers
• Lead and coach a team of prior authorization specialists
• Review patient records to determine clinical necessity for treatments
• Stay updated on payer policies and reimbursement guidelines
• Collaborate with providers, patients and nurses to resolve delays or denials
• Generate reports on performance metrics and denials reasons
• Ensure compliance with regulatory guidelines and quality standards

Skills

Team leadership

Clinical review

Payer management

Data analysis

Communication

Problem solving

Education

Bachelor’s degree in nursing, pharmacy, or healthcare administration

Master’s degree preferred

Job description

Clearview Cancer Institute is seeking a Senior Oncology Prior Authorization Manager to lead a team of specialists in obtaining timely approvals for hematology and oncology treatments. You will review clinical data, coordinate with insurers and providers, and drive process improvements to reduce denials and delays.

Ideal candidates have oncology PA leadership experience, strong analytics, and exceptional communication skills to collaborate with care teams.