Senior Manager-Business Operations

Medical University of South Carolina; Charleston (SC); On-site; USD 110,000 - 150,000; Full time

Benefits offered by this job

Health insurance

Employer Sponsored Retirement Plan

Paid time off and extended sick leave

Tuition Reimbursement

Certification incentive program

Flexible schedule options

Employee referral program

Job summary

The Senior Manager of Preauthorization Services at MUSC Community Physicians leads strategic and operational efforts across preauthorization activities to ensure timely, accurate insurance authorizations and optimal reimbursement. You will partner with clinical, access, coding, billing, and payer relations teams to align workflows with organizational goals.

Responsibilities include setting department goals, standardizing authorizations, analyzing denial trends, and driving continuous improvement

Qualifications

• Bachelor's degree or equivalent education and/or relevant work experience.
• Experience leading preauthorization and revenue cycle processes.
• Strong knowledge of payer requirements and regulatory guidelines.

Responsibilities

• Provide strategic direction and day-to-day leadership for preauthorization services across inpatient, outpatient, and procedural areas.
• Design, implement, and standardize authorization workflows to ensure efficiency, scalability, and compliance.
• Establish departmental goals, KPIs, and performance benchmarks aligned with revenue cycle objectives.
• Lead change initiatives to support new service lines and payer requirements.
• Monitor denial trends and drive corrective actions with denial management teams.

Skills

Strategic leadership

Cross-functional collaboration

Performance tracking

Lean Six Sigma

Education

Bachelor's degree or equivalent

Job description

Job Description Summary

MUSC Community Physicians (MCP) is an entity within the Medical University of South Carolina (MUSC) that provides healthcare to patients within the rural health network throughout the state of South Carolina.

Entity

MUSC Community Physicians (MCP)

Worker Type

Employee

Worker Sub-Type

Regular

Cost Center

CC004513 MCP - Revenue Cycle

Pay Rate Type

Salary

Pay Grade

Health-32

Scheduled Weekly Hours

40

Job Description

The Senior Manager of Preauthorization Services is responsible for the strategic oversight, operational management, and continuous improvement of all preauthorization and prior approval activities across the hospital or health system. This role ensures timely, accurate, and compliant insurance authorizations to support optimal reimbursement, reduce denials, and enhance patient access and satisfaction. The Senior Manager partners closely with clinical, access, coding, billing, and payer relations teams to align preauthorization processes with revenue cycle best practices and organizational goals.

1. Strategic & Operational Leadership – 30%

• Provide strategic direction and day-to-day leadership for all preauthorization services across inpatient, outpatient, and procedural areas.
• Design, implement, and standardize authorization workflows to ensure efficiency, scalability, and compliance.
• Establish departmental goals, KPIs, and performance benchmarks aligned with revenue cycle and organizational objectives.
• Lead change initiatives to support new service lines, payer requirements, and organizational growth.

2. Revenue Integrity & Financial Performance – 25%

• Ensure timely and accurate authorizations to minimize denials, delays in billing, and revenue leakage.
• Analyze authorization-related denial trends and collaborate with denial management and appeals teams to drive corrective action.
• Monitor financial performance metrics including authorization-related denial rates, clean claim rates, and impact to net revenue.
• Support clean claims and timely billing through strong upstream authorization practices.

3. Team Leadership & Talent Development – 20%

• Directly manage managers, supervisors, and/or team leads within preauthorization services.
• Recruit, develop, and retain a high-performing workforce through coaching, performance management, and succession planning.
• Establish productivity standards and accountability measures while promoting employee engagement and professional growth.
• Foster a culture of collaboration, service excellence, and continuous improvement.

4. Payer, Clinical & Stakeholder Collaboration – 15%

• Serve as the primary operational liaison with payers related to authorization requirements, escalations, and process improvements.
• Partner with clinical leaders, physicians, patient access, scheduling, case management, and billing teams to align workflows.
• Support payer meetings and contract discussions by providing data and operational insight related to authorization performance.
• Communicate authorization requirements and changes clearly to internal stakeholders.

5. Compliance, Quality & Process Improvement – 10%

• Ensure compliance with payer contracts, CMS regulations, and organizational policies.
• Maintain current knowledge of medical necessity guidelines and evolving authorization requirements.
• Lead quality assurance audits, root cause analyses, and corrective action plans.
• Leverage data analytics, automation, and process improvement methodologies (Lean, Six Sigma) to enhance performance.

Education: Bachelor's degree or equivalent education and/or relevant work experience Work Experience: 8 years progressive work experience and 3 years management experience

Additional Job Description

Benefits

• Health, dental, vision, and life insurance
• Employer Sponsored Retirement Plan
• Paid time off and extended sick leave
• Paid Parental Leave
• Disability insurance plan options
• Continuous professional and clinical training
• Competitive pay
• Annual Merit Increase
• Wellbeing resources
• Tuition Reimbursement
• Employee perks and discounts
• Employee referral program
• Flexible schedule options
• Certification incentive program

If you like working with energetic enthusiastic individuals, you will enjoy your career with us!

The Medical University of South Carolina is an Equal Opportunity Employer. MUSC does not discriminate on the basis of race, color, religion or belief, age, sex, national origin, gender identity, sexual orientation, disability, protected veteran status, family or parental status, or any other status protected by state laws and/or federal regulations. All qualified applicants are encouraged to apply and will receive consideration for employment based upon applicable qualifications, merit and business need.

Medical University of South Carolina participates in the federal E-Verify program to confirm the identity and employment authorization of all newly hired employees. For further information about the E-Verify program, please click here: http://www.uscis.gov/e-verify/employees