Strategic Account Operations Manager – Medical Prior Authorization

McKesson•Columbus, OH

6d•$100,500 - $167,500

About The Position

Reporting to the Director, Account Operations, the Strategic Account Operations Manager (Medical Prior Authorization) is responsible for overseeing complex customer relationships, programs, and initiatives focused on medical benefit prior authorization and front-end access services. We are seeking an experienced account operations leader with deep medical PA expertise and strong client-facing operational experience to support strategic programs critical to CoverMyMeds’ evolving access strategy. This role will help build and mature CMM’s medical PA capabilities while ensuring high-quality, scalable execution for assigned customers. This position owns a portfolio of highly complex, strategic programs and serves as a trusted operational advisor to customers, internal stakeholders, and cross-functional partners. The ideal candidate is comfortable operating in ambiguity, understands payer–provider–vendor dynamics, and can translate medical PA complexity into repeatable, operationally sound solutions.

Requirements

Bachelor’s degree or equivalent experience
7+ years of experience in account management, operations, or program leadership roles within healthcare
Direct experience supporting medical prior authorization workflows, ideally within medical benefit (not pharmacy-only) programs
Strong understanding of payer policies, provider workflows, and prior authorization lifecycle concepts
Demonstrated success managing complex, multi-stakeholder programs and customer relationships
Proven ability to lead through ambiguity, particularly during product evolution or operational change
Excellent communication skills, with the ability to communicate effectively with operational, technical, clinical, and executive stakeholders
Expertise in medical PA operations, including pre-authorizations, determinations, appeals, and payer-provider workflows
Strong operational and account leadership skills, including SLA oversight, risk mitigation, and service optimization
Ability to analyze and interpret operational data to drive insights and recommendations
Skilled in problem-solving complex customer and operational issues under pressure
Track record of building trust and credibility across internal teams and external partners
Strong project and process management capabilities in cross-functional environments

Nice To Haves

Experience working with healthcare technology platforms, EHR-integrated workflows, or access solutions strongly preferred
PACS certification preferred
Working knowledge of Salesforce (SFDC) or similar CRM tools preferred

Responsibilities

Serves as the primary point of contact for day-to-day oversight and management of multiple, complex, and strategic medical prior authorization and front end access programs, ensuring strong customer engagement, satisfaction, and retention
Owns operational delivery of medical PA and front end access–related contract deliverables, ensuring adherence to contractual terms, service-level expectations, and regulatory requirements
Acts as the initial escalation point for complex program issues, independently researching, resolving, and communicating corrective actions; escalates appropriately and partners with internal teams as needed
Develops, documents, and maintains program plans for medical PA and access services, tracking progress against goals, identifying operational risks, and implementing mitigation strategies
Leverages medical benefit, payer policy, and prior authorization workflow knowledge to proactively identify trends, risks, and improvement opportunities across assigned programs
Proactively utilizes data and reporting (payer metrics, authorization outcomes, turnaround times, denial trends, volume forecasts) to inform recommendations and operational decisions
Drives a culture of continuous improvement and operational excellence, leading process optimization efforts related to medical PA workflows, front-end services, and scaled support models
Serves as a subject-matter resource for medical PA within the Account Operations organization, advising peers and mentoring less-experienced team members
Partners cross-functionally with Product, Network Services, Implementation, Support, Legal, Compliance, and Sales to ensure alignment between customer needs, product capabilities, and operational delivery
Participates in and/or leads strategic initiatives tied to the evolution of CMM’s medical PA, access, and front-end service offerings
Represents Account Operations in customer-facing discussions, including operational reviews, issue resolution meetings, and planning sessions
Travel to client sites and industry events as needed (approximately 10–15%)