Prior Authorization Product Analyst

Oracle

93d

About The Position

Oracle Clinical AI Assistant (CAA) enables providers to demonstrate the power of generative AI together with voice commands to reduce manual documentation and clinical tasks, so they can focus more attention on patient care. Our diverse team of creators and inventors are building the future of conversational clinical interfaces, making real improvements in the lives of people across the world. We act with the speed and attitude of a start-up, but with the scale and customer focus of the world’s leading enterprise software company. We have a big charter and a lot of creative freedom to get it done. Come join us and grow your career in this exciting arena. We are looking for a Prior Authorization Product Analyst to drive the features and capabilities of the prior authorization aspect of the CAA. As part of the Oracle Health AI Product Management team, you will contribute to products geared toward physician efficiency and clinical assistance. This role is critical to alleviating burnout for healthcare workers and improving patient experiences.

Requirements

• Associate’s or Bachelor's Degree or equivalent experience in Healthcare Administration, Nursing, Health Information Management, Public Health, or Business (with healthcare focus)
• Minimum of 3+ years in healthcare operations, specifically in prior authorization management in a hospital or physician practice
• Direct experience with managing prior authorization requests end-to-end
• Experience communicating with insurance companies and clinical staff
• Ability to navigate denials and appeals
• Strong understanding of prior authorization processes, payer guidelines, medical necessity criteria, and regulatory compliance (HIPAA, CMS, ACA, etc.)
• Strong analytical skills with the ability to identify process inefficiencies and design practical solutions
• Excellent verbal and written communication skills, with the ability to explain complex technical concepts to non-technical stakeholders and collaborate effectively with cross-functional teams.

Nice To Haves

• Certified Prior Authorization Specialist (CPAS)
• Certified Professional Coder (CPC)
• Certified Medical Administrative Assistant (CMAA)
• Certified Revenue Cycle Representative (CRCR)
• Certified Healthcare Access Associate (CHAA)
• Registered Health Information Technician (RHIT)
• Medical Billing and Coding Certification

What This Job Offers

• Career Level: Mid Level
• Education Level: Bachelor's degree
• Number of Employees: 5,001-10,000 employees