Remote Director: Outpatient Authorizations & Referrals

Mass General Brigham; Somerville (MA); On-site; USD 124,000 - 181,000; Full time

Job summary

Mass General Brigham, a prominent healthcare system, is seeking a leader to oversee financial clearance operations focusing on eligibility verification, benefits coordination, and prior authorizations. You will work closely with patient access, billing and managed care teams to streamline processes and ensure compliance.

The role requires extensive experience in revenue cycle management and leadership, with a strong emphasis on data-driven improvements and staff development.

Qualifications

• Bachelor's degree in Healthcare Administration, Business, Finance or related field required
• Master's degree in related field preferred

Responsibilities

• Oversee financial clearance operations including eligibility verification and prior authorization processes
• Collaborate with patient access, billing and managed care to optimize workflows and reduce delays
• Develop and implement policies to ensure regulatory compliance and payer guidelines
• Monitor performance metrics and drive improvements in financial clearance
• Manage payer relationships and resolve coverage/authorization issues
• Lead training and development of financial clearance staff
• Analyze denials/authorizations trends and reduce financial risk
• Prepare reports for senior leadership on activities and performance
• Ensure accurate data collection and documentation for patient financial records

Skills

Payer regulations

Revenue cycle analytics

Cross-functional collaboration

Communication skills

Leadership and staff development

Education

Bachelor's degree in related field

Master's degree preferred

Job description

Mass General Brigham, a prominent healthcare system, is seeking a leader to oversee financial clearance operations focusing on eligibility verification, benefits coordination, and prior authorizations. You will work closely with patient access, billing and managed care teams to streamline processes and ensure compliance.

The role requires extensive experience in revenue cycle management and leadership, with a strong emphasis on data-driven improvements and staff development.