Remote Prior Authorization Lead

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

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.