Remote Lead: Prior Authorization & Referrals

Brigham and Women's Hospital; Boston (MA); Remote; USD 35,000 - 50,000; Full time

Benefits offered by this job

Medical

Dental

Vision

403b retirement plan

Tuition reimbursement

MBTA pass discount

Job summary

The Brigham and Women’s Hospital is seeking a supervisor for the Prior Authorization and Referral team. This role will oversee daily operations, mentor staff, and ensure timely, compliant submissions to payers.

You will monitor Epic and Tableau dashboards and coordinate across departments to resolve complex cases. The ideal candidate has 3–5 years in prior authorization, Epic experience, and strong leadership skills to drive process improvements in a fast-paced hospital setting.

Qualifications

• Experience with prior authorization and medical billing processes.
• Leadership experience in healthcare operations.
• Strong verbal and written communication with stakeholders.
• Proficiency with Epic and other EHR systems.

Responsibilities

• Oversee daily operations of the prior authorization and referral department.
• Mentor and train team members to ensure efficient workflow.
• Review dashboards (Epic/Tableau) to forecast staffing needs.
• Ensure payer requirements and HIPAA compliance are met in submissions.
• Identify and implement process improvements to reduce turnaround times.
• Resolve complex denial and appeal cases with providers and payors.

Skills

Prior authorization

Leadership

Communication

EHR systems

Analytical skills

Healthcare regulations

Education

High school diploma or equivalent

Associate’s degree (preferred)

Tools

Epic

Tableau

Job description

The Brigham and Women’s Hospital is seeking a supervisor for the Prior Authorization and Referral team. This role will oversee daily operations, mentor staff, and ensure timely, compliant submissions to payers.

You will monitor Epic and Tableau dashboards and coordinate across departments to resolve complex cases. The ideal candidate has 3–5 years in prior authorization, Epic experience, and strong leadership skills to drive process improvements in a fast-paced hospital setting.