Colorado Medicaid Authorization Manager

Job Summary

A company is looking for a Payor Authorization Operations Manager.

Key Responsibilities:

• Lead authorization operations for Colorado's HCBS waiver programs and Long Term Home Health services, ensuring compliance with policies and system requirements
• Manage the prior authorization process and oversee a team of Doc Collectors and Re-Authorization Associates
• Serve as the escalation point for disputed Medicaid authorizations and coordinate with internal teams to resolve authorization issues

Required Qualifications:

• 5+ years of experience in Colorado Medicaid authorization with a track record of managing complex portfolios
• Bachelor's degree in Healthcare Administration, Business, or equivalent preferred; certification and training in Colorado Medicaid and LTHH authorization strongly preferred
• Deep knowledge of Colorado's LTHH ecosystem, including prior authorization operations and case coordination
• Expert relationship builder with proven ability to work effectively with state agencies and payer entities
• Process-driven operator with experience in CRM systems and data analysis