Remote Prior Authorization Manager, Obesity Care Operations

knownwell; United States; Remote; USD 90,000 - 130,000; Full time

Benefits offered by this job

Remote work

Insurance benefits

401K match

PTO and holidays

Parental leave

Job summary

knownwell is seeking a Manager, Prior Authorization to lead a team responsible for securing insurance approval for obesity management medications and care plans. This is a high-visibility operational leadership role impacting patient access and outcomes.

You will manage both in-house and outsourced resources, own vendor relationships, and drive continuous improvement in how requests are tracked, escalated, and resolved.

Qualifications

• 5-7 years of prior authorization experience, including 3+ years in a leadership role managing a Prior Authorization or similar insurance-facing operations team.
• Deep working knowledge of the Prior Authorization lifecycle and payer requirements.
• Experience managing distributed or blended teams (in-house + BPO/outsourced).
• Track record of building process and measuring it with structured tracking and metrics.

Responsibilities

• Manage and coach a team of Prior Authorization specialists across in-house and outsourced resources.
• Own outsourced staffing vendor relationship, including capacity planning and quality oversight.
• Own PA turnaround time, coverage rate, and backlog metrics; maintain visibility into team performance.
• Drive status tracking and work-list management in Athena and CoverMyMeds.
• Evolve PA competency frameworks, training materials, and SOPs for complex payer requirements.
• Partner with clinicians on complex cases and escalations.
• Identify and fix process or tooling breakdowns affecting patients.
• Lead hiring, onboarding, and ramp-up of new team members.
• Report PA performance and risk to Central Operations leadership.

Skills

Prior Authorization

Leadership

Vendor management

Process improvement

Cross-functional communication

Tools

CoverMyMeds

Athena

Job description

knownwell is seeking a Manager, Prior Authorization to lead a team responsible for securing insurance approval for obesity management medications and care plans. This is a high-visibility operational leadership role impacting patient access and outcomes.

You will manage both in-house and outsourced resources, own vendor relationships, and drive continuous improvement in how requests are tracked, escalated, and resolved.