Prior Authorization Team Lead

Job Summary

A company is looking for a Prior Authorization Team Lead to oversee prescription prior authorization operations.

Key Responsibilities

• Lead and manage prescription prior authorization operations, ensuring accuracy and timely approvals
• Own the end-to-end prior authorization process, including intake, submission, follow-up, and resolution
• Serve as the primary operational contact for the BPO partner, overseeing productivity and quality performance

Required Qualifications

• Minimum 3 years of experience managing prescription prior authorizations in a healthcare setting
• Experience managing a BPO partner with a focus on SLA management and performance oversight
• Proven experience with complex medications, particularly GLP-1 authorization
• Prior people leadership experience with accountability for output and quality
• Strong knowledge of payer rules, documentation standards, and appeal processes