Senior Medical Authorization & AI Workflow Lead

Obsidian; San Francisco (CA); Remote; USD 90,000 - 120,000; Full time

Job summary

Obsidian is seeking an experienced Prior Authorisation Manager in San Francisco to support AI tools designed to streamline prior authorisation workflows. Ideal candidates will have over 5 years in prior authorisation or clinical review and deep clinical expertise including familiarity with InterQual and payer processes.

This role involves managing workflows, reviewing clinical documentation, and collaborating with stakeholders to improve patient access. Join us to contribute to cutting-edge AI systems shaping the future of healthcare.

Qualifications

• 5+ years of experience in prior authorisation, utilisation management, or clinical review.
• Strong clinical background with knowledge of medical necessity criteria (InterQual, MCG).
• Exceptional written and verbal English communication skills.

Responsibilities

• Manage end-to-end prior authorisation workflows across multiple payer types.
• Review clinical documentation to assess medical necessity.
• Coordinate with clinical staff and payers to obtain authorisation approvals.

Skills

Prior authorisation management

Clinical documentation review

Utilisation management

AI tools evaluation

English communication

Education

5+ years of experience in prior authorisation or clinical review

Clinical licensure (RN, LPN or equivalent)

Tools

EHR platforms (Epic, Cerner)

Job description

Obsidian is seeking an experienced Prior Authorisation Manager in San Francisco to support AI tools designed to streamline prior authorisation workflows. Ideal candidates will have over 5 years in prior authorisation or clinical review and deep clinical expertise including familiarity with InterQual and payer processes.

This role involves managing workflows, reviewing clinical documentation, and collaborating with stakeholders to improve patient access. Join us to contribute to cutting-edge AI systems shaping the future of healthcare.