Strategic Preauthorization Operations Leader

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

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