Remote Director, Prior Authorization & Appeals

Kestra Medical Technologies Inc.; Kirkland (WA); On-site; USD 100,000 - 120,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

401K with Match

Job summary

Kestra Medical Technologies Inc. seeks an experienced leader to head the Prior Authorization team. This role ensures timely submissions, accurate outcomes, and effective appeals while coordinating with across departments to optimize workflows.

Strong focus on clinical relevance and policy adherence guides decision making. The position emphasizes mentorship, vendor management, and driving automation to reduce revenue leakage.

Qualifications

• 3-5 years of leadership in the healthcare revenue cycle management function, with focus on prior authorization management.
• Strong understanding of clinical review and prior authorization management.
• Proven record of achieving aggressive metrics and outcomes.

Responsibilities

• Oversee all aspects of the Prior Authorization department, including submission, renewals, follow-up, and appeals.
• Analyze clinical reviews and outcomes, denial reporting, and appeal effectiveness.
• Collaborate with other departments to manage the end-to-end prior authorization process.
• Promote ongoing communication and cross-functional projects for optimization.
• Ensure metrics are achieved and develop plans to address deficits.
• Provide orientation and ongoing training for staff.
• Drive automation, workflow improvements, and efficiency gains.
• Partner with internal/external customers to improve approval outcomes and minimize revenue leakage.
• Hire and manage staff, fostering respect, accountability, and results.

Skills

Healthcare revenue cycle leadership

Prior authorization management

Analytics & metrics tracking

Cross-functional collaboration

Tools

Vendor management relationships

Job description

Kestra Medical Technologies Inc. seeks an experienced leader to head the Prior Authorization team. This role ensures timely submissions, accurate outcomes, and effective appeals while coordinating with across departments to optimize workflows.

Strong focus on clinical relevance and policy adherence guides decision making. The position emphasizes mentorship, vendor management, and driving automation to reduce revenue leakage.