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
• Oversee the prior authorization process and manage a team to maintain adherence to payer requirements
• Build and manage the reauthorization submission process to ensure uninterrupted patient care

Required Qualifications:

• 5+ years of Colorado Medicaid authorization experience with a track record of managing complex portfolios
• Bachelor's degree in Healthcare Administration, Business, or equivalent preferred
• Deep knowledge of Colorado's LTHH ecosystem, including HCPF policies and prior authorization operations
• Expert relationship builder with proven ability to work with state agencies and payer entities
• High-agency operator with experience in CRM systems and metrics-focused processes