Senior Manager, Authorization Operations

VNS Health; New York (NY); Vor Ort; USD 77.000 - 97.000; Vollzeit

Benefits dieser Stelle

Referral bonus opportunities

30 days PTO + 9 holidays

Health insurance for you and family

Employer-matched retirement savings

FSAs for healthcare and dependent care

Tuition reimbursement

Professional growth and career advance

Internal mobility and CEU credits

Zusammenfassung

VNS Health is seeking a qualified leader to oversee Authorization Operations, guiding non-clinical teams and ensuring compliance with DOH and CMS guidelines. You will shape policies, monitor performance, and drive timely, satisfactory resolutions for member inquiries and complaints.

In this role, you’ll collaborate with clinical and non-clinical staff, implement process improvements, and manage training to elevate service quality.

Qualifikationen

• Bachelor's degree in Business, Healthcare or related field required.
• Master's degree in Business, Healthcare or related field preferred.
• Minimum six years of progressive management experience, preferably in a customer service or health care environment.
• Minimum two years managerial experience in managed care required.
• Experience with writing and implementing program-level policy and procedures and workflows.

Aufgaben

• Manages implementation and operational management of Authorization Operations Teams and policies to ensure compliance and timeliness.
• Acts as SME to internal staff and external Provider staff regarding authorization requests and inquiries.
• Evaluates policies and procedures; collaborates to ensure adherence to regulations and guidelines.
• Directs investigations related to member complaints and establishes efficient workflows for timely operations.
• Assists management in developing long and short-range objectives including system rollouts and cross-team coordination.
• Provides training to staff as needed and supports Education and Quality departments.

Kenntnisse

Operational leadership

Process improvement

Regulatory compliance

Staff development

Customer service

Ausbildung

Bachelor's Degree in Business/Healthcare

Master's Degree preferred

Tools

Microsoft Word

Excel

Jobbeschreibung

VNS Health is seeking a qualified leader to oversee Authorization Operations, guiding non-clinical teams and ensuring compliance with DOH and CMS guidelines. You will shape policies, monitor performance, and drive timely, satisfactory resolutions for member inquiries and complaints.

In this role, you’ll collaborate with clinical and non-clinical staff, implement process improvements, and manage training to elevate service quality.