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 requirements
• Oversee the prior authorization process and manage a team while maintaining knowledge of payer requirements
• Build and manage reauthorization processes to ensure continuous patient care without lapses

Required Qualifications:

• 5+ years of experience in Colorado Medicaid authorization with a strong track record in managing complex portfolios
• Bachelor's degree in Healthcare Administration, Business, or equivalent preferred; certification and training in LTHH authorization strongly preferred
• Deep knowledge of Colorado's LTHH ecosystem, including policies and prior authorization operations
• Proven ability to build relationships and work effectively with state agencies and payer entities
• Experience in navigating ambiguous regulatory environments with a focus on metrics and process execution