Remote Prior Authorization Program Manager

Gainwell Technologies LLC; Wisconsin; Remote; USD 76,000 - 108,000; Full time

Benefits offered by this job

401(k) employer match

Health benefits

Educational assistance

Flexible vacation policy

Job summary

Gainwell Technologies LLC is seeking a Prior Authorization Manager to lead a team delivering healthcare utilization services. The role focuses on overseeing staff performance, optimizing processes, and ensuring high-quality outcomes for account delivery.

You will manage day-to-day operations, establish routines, train staff, and maintain strong client satisfaction while driving adherence to SLAs and OPs. Remote work is supported with occasional exceptions.

Qualifications

• 7+ years of people management experience in healthcare.
• Experience in quality assurance to support accurate utilization decisions based upon nationally recognized guidelines.
• Minimum of two years’ Medicaid experience in Prior Authorization/Utilization Review preferred.
• Proficient with Microsoft Office suite required and experience with software applications to manage and back-office operations preferred.
• Strong written and oral communication and interpersonal skills to work effectively with team members, customers, and clients.
• Demonstrated strategic initiative implementation and execution, specifically with operating policies and procedures and work process improvements in operations.

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 effectively 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.
• Effectively cultivate relationships with account leaders and business partners to proactively identify and enact opportunities to improve the 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 and contributions.
• Identify and manage existing and emerging risks from business activities and implement mitigation strategies to improve performance.

Skills

People management

Communication

Healthcare knowledge

Quality assurance

Tools

Microsoft Office

Job description

Gainwell Technologies LLC is seeking a Prior Authorization Manager to lead a team delivering healthcare utilization services. The role focuses on overseeing staff performance, optimizing processes, and ensuring high-quality outcomes for account delivery.

You will manage day-to-day operations, establish routines, train staff, and maintain strong client satisfaction while driving adherence to SLAs and OPs. Remote work is supported with occasional exceptions.