Program Manager, Prior Authorizations (Remote)

Availity

4d • Remote

About The Position

Availity delivers revenue cycle and related business solutions for health care professionals who want to build healthy, thriving organizations. Availity has the powerful tools, actionable insights and expansive network reach that medical businesses need to get an edge in an industry constantly redefined by change. At Availity, we're not just another Healthcare Technology company; we're pioneers reshaping the future of healthcare! With our headquarters in vibrant Jacksonville, FL, and an exciting office in Bangalore, India, along with an exceptional remote workforce across the United States, we're a global team united by a powerful mission. We're on a mission to bring the focus back to what truly matters - patient care. As the leading healthcare engagement platform, we're the heartbeat of an industry that impacts millions. With over 3 million providers connected to health plans, and processing over 19 billion transactions annually, our influence is continually expanding. Join our energetic, dynamic, and forward-thinking team where your ideas are celebrated, innovation is encouraged, and every contribution counts. We're transforming the healthcare landscape, solving communication challenges, and creating connections that empower the nation's premier healthcare ecosystem. Sponsorship, of any kind, is not available for this role. Overview of the role: The Program Manager is responsible for leading post‑sales healthcare implementations, ensuring customers move efficiently from contract signature through delivery in a complex, fast‑paced environment. This role manages multiple concurrent implementations, coordinating cross‑functional dependencies with product, engineering, and Solutions Engineering teams while adapting to shifting timelines and capacity constraints. The Program Manager may assist with the analysis of project, program, and operational data to align the outcome of projects with Availity strategic, product and business goals. You will determine the optimal mix of resources and sequencing of projects within their program to best achieve the company's overall goals while managing costs and client expectations. The Program Manager must have excellent communication and presentation skills and the ability to relate to customers at the project and executive level. Sponsorship, in any form, is not available for this position.

Requirements

• Experience managing multiple, complex implementations and strategic initiatives within the healthcare space.
• Healthcare background is required to be considered for the role.
• Technical acumen.
• The ideal candidate is familiar with X12, FHIR, and understands prior authorization workflows.
• Possess strong written and oral communication skills.
• Experience working directly with multiple levels of customers (Project Managers to C-Level Executives), this is a client facing position.
• Proven track record in managing/influencing cross functional teams (technology and business).
• Demonstrated political awareness and ability to diplomatically handle sensitive situations with internal and external customers and ability to cultivate effective, productive customer relationships and partnerships.
• Demonstrated balance of business, operational, and technical experience in customer delivery.
• Proven ability to independently assume ownership of active projects, establish priorities, and successfully deliver outcomes with minimal oversight.
• Ability to quickly evaluate project progress, identify gaps, align stakeholders, and drive initiatives to completion with limited direction.
• Must have the ability to tailor communications and discussions to the applicable audiences.
• If you are not able to use your camera for all virtual meetings, you should not apply for this role.
• Video participation is required to ensure that only authorized personnel are present in meetings and to prevent unauthorized access, data breaches, preventing social engineering, or the sharing of confidential information with non-participants.

Nice To Haves

• An in-depth understanding of the prior authorization end to end process from providers to payers.
• Familiarity with APIs and FHIR

Responsibilities

• Leading internal and external teams on the day-to-day oversight of project deliverables, working business and technical requirements along with a technical delivery plan, deployment plans, operational project plans, etc.
• Managing strategic Health Plan implementations.
• Establishing and maintaining relationships with key stakeholders at multiple levels within the Health Plan.
• Preparing and presenting material associated with the implementation including kick-off meetings, program status (including C level stakeholders), etc.
• Working cross-functionally with many internal Availity teams: product, engineering, client services, strategic account services, provider services, provider engagement and training, clinical operations, and many more.
• Accountable to team and customer Key Performance Indicators as a measure of success.

Benefits

• competitive salary
• bonus structure
• generous HSA company contribution
• healthcare
• vision
• dental benefits
• 401k match program
• unlimited PTO for salaried associates
• 9 paid holidays
• reimbursement up to $250/year for gym memberships, participation in racing events, weight management programs, etc.
• education reimbursement
• Paid Parental Leave for both moms and dads, both birth parents and adoptive parents.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed