Remote Senior Prior Authorization Manager

Mass General Brigham (Enterprise Services); Somerville (MA); Remote; USD 80,000 - 116,000; Full time

Benefits offered by this job

HIPAA-compliant workstation

Remote role (M-F EST)

Job summary

Mass General Brigham is seeking a leader to oversee the prior authorization and referral teams from a revenue cycle perspective. You will guide hiring, training, and performance reviews while ensuring compliant, efficient processes, and collaboration with clinical staff.

Qualifications include a healthcare or business-related bachelor’s degree and 5–7 years in revenue cycle operations, with 2–3 years in a management role. Epic experience is preferred. Remote role with M-F Eastern hours.

Qualifications

• Bachelor’s degree in healthcare administration or business administration or related field.
• 5-7 years experience in revenue cycle operations.
• 2-3 years in a management role.
• Epic experience preferred.

Responsibilities

• Leads the prior authorization and referral team, including hiring, training, and evaluating staff performance.
• Oversees insurance verification, authorization, and referral procurement/verification processes to ensure timely and accurate patient information.
• Implements and monitors policies and procedures to maintain compliance with regulatory and payer requirements, including authoring departmental standard‑of‑work documents.
• Collaborates with clinical and administrative teams to resolve prior authorization issues that impact patient care or billing.
• Analyzes authorization metrics to identify trends and opportunities for process improvements.
• Mentors and develops team members through annual performance reviews, scheduled touch bases, and goal planning.
• Develops and delivers training programs to enhance staff knowledge of insurance guidelines and authorization requirements.

Skills

Insurance verification

Billing practices

Healthcare regulations

Leadership

Team management

Revenue cycle management

Financial clearance processes

Analytical skills

Communication & interpersonal skills

Education

Bachelor's Degree Healthcare Administration

Bachelor's Degree Business Administration

Bachelor's Degree Related Field of Study

Tools

Epic

Job description

Mass General Brigham is seeking a leader to oversee the prior authorization and referral teams from a revenue cycle perspective. You will guide hiring, training, and performance reviews while ensuring compliant, efficient processes, and collaboration with clinical staff.

Qualifications include a healthcare or business-related bachelor’s degree and 5–7 years in revenue cycle operations, with 2–3 years in a management role. Epic experience is preferred. Remote role with M-F Eastern hours.