Prior Authorization Manager

Gainwell Technologies LLC; Columbus (OH); Remote; USD 76,000 - 108,000; Full time

Benefits offered by this job

Flexible vacation policy

401(k) match

Health benefits

Educational assistance

Leadership academies

Technical development academies

Job summary

Gainwell Technologies LLC is seeking a Manager to lead healthcare-focused teams delivering high-quality operational outcomes. You will oversee performance, coach staff, and optimize processes within a flexible, remote role.

The role emphasizes Medicaid experience, QA practices, and strong written/oral communication to drive client satisfaction and SLA achievement. Opportunities for growth and career development are offered.

Qualifications

• 7+ years of people management experience in healthcare.
• Experience in quality assurance to support accurate utilization decisions based on nationally recognized guidelines.
• Minimum of two years' Medicaid experience in Prior Authorization/Utilization Review preferred.
• Proficient with Microsoft Office suite and experience with software applications to manage and back-office operations.
• Strong written and oral communication and interpersonal skills.
• Demonstrated strategic initiative implementation and execution with operating policies and procedures.

Responsibilities

• Build, develop, and lead teams of leaders and individual contributors, supporting employees and executing day-to-day operations delivery for an account(s).
• Establish and lead routines regularly and utilize tools and reporting to drive team performance; train and provide ongoing coaching to ensure employee engagement while maintaining client satisfaction.
• Cultivate relationships with account leaders and business partners to identify and enact opportunities to improve delivery of operational products, services, and capabilities.
• Work with employees and operational leaders to achieve Client Service Level Agreements (SLAs) and drive accountability and efficiency by adopting standard operating procedures.
• Create conditions for success by removing obstacles and championing change to drive employee awareness and a connection to their work.
• Identify and manage existing and emerging risks from business activities and implement mitigation strategies to improve performance.

Skills

People management

Healthcare experience

Quality assurance

Medicaid experience

Microsoft Office

Communication skills

Process improvement

Tools

Microsoft Office

Job description

Summary

Great companies need great teams to propel their operations. Join the group that solves business challenges and enhances the way we work and grow. Working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values your contributions and puts a premium on work flexibility, learning, and career development.

As a Manager at Gainwell, you will be part of an innovative product company with a mission to serve the healthcare needs of our communities. You will oversee and guide your team to deliver superior service and achieve account goals and outcomes. You manage the performance and engagement of your staff, optimize processes, and maintain the highest quality standards.

Your role in our mission

Gainwell empowers you through innovative technologies and solutions to deliver better health and human services outcomes. When joining Gainwell, you will:

• Build, develop, and lead teams of leaders and individual contributors, supporting employees and executing day-to-day operations delivery for an account(s).
• Establish and effectively lead routines regularly and utilize tools and reporting to drive team performance; train and provide ongoing coaching to ensure employee engagement while maintaining client satisfaction.
• Effectively cultivate relationships with account leaders and business partners to proactively identify and enact opportunities to improve the delivery of operational products, services, and capabilities.
• Work with employees and operational leaders to achieve Client Service Level Agreements (SLAs) and drive accountability and efficiency by adopting standard operating procedures.
• Create conditions for success by removing obstacles and championing change to drive employee awareness and a connection to their work and contributions.
• Identify and manage existing and emerging risks from business activities and implement mitigation strategies to improve performance.

What we're looking for

• 7 or more years of people management experience in healthcare.
• Experience in quality assurance to support accurate utilization decisions based upon nationally recognized guidelines
• Minimum of two years' Medicaid experience in Prior Authorization/Utilization Review preferred.
• Proficient with Microsoft Office suite required and experience with software applications to manage and back-office operations preferred.
• Strong written and oral communication and interpersonal skills to work effectively with team members, customers, and clients.
• Demonstrated strategic initiative implementation and execution, specifically with operating policies and procedures and work process improvements in operations.

What you should expect in this role

• Remote

The pay range for this position is $75,700 - $108,100 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors. Put your passion to work at Gainwell. You’ll have the opportunity to grow your career in a company that values work flexibility, learning, and career development.

All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a 401(k) employer match, comprehensive health benefits, and educational assistance.

• flexible vacation policy
• 401(k) employer match
• comprehensive health benefits
• educational assistance
• We also have a variety of leadership and technical development academies to help build your skills and capabilities

We believe nothing is impossible when you bring together people who care deeply about making healthcare work better for everyone. Build your career with Gainwell, an industry leader. You’ll be joining a company where collaboration, innovation, and inclusion fuel our growth. Learn more about Gainwell at our company website and visit our Careers site for all available job role openings.

Gainwell Technologies is an Equal Opportunity Employer, where all qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical condition), age, sexual orientation, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. Gainwell Technologies defines "wages" and "wage rates" to include "all forms of pay, including, but not limited to, salary, overtime pay, bonuses, stock, stock options, profit sharing and bonus plans, life insurance, vacation and holiday pay, cleaning or gasoline allowances, hotel accommodations, reimbursement for travel expenses, and benefits.