Supervisor, Authorization

Centene Corporation

About The Position

You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: Supervises the prior authorization request process for required authorizations to ensure work queue is managed and addressed properly and timely. Supervises day-to-day activities and provides guidance to the authorization team on documenting and resolving all authorization requests and/or issues to ensure accurate and timely documentation for services related to the members healthcare eligibility and access. Ensures authorization team’s compliance with contract requirements, policies, procedures, and performance standards. Monitors authorization requests inventory to ensure proper resources allocation throughout the day. Maintains knowledge of contract requirements, policies, procedures, and performance standards. Works with authorization team and senior management to identify opportunities for process and quality improvements within authorization request processes. Evaluates authorization team performance and provides feedback regarding performance, goals, and career milestones. Provides coaching and guidance to authorization team for SLAs and department productivity goals to ensure accurate and timely documentation for services and improve processing and quality of authorization requests. Proactively monitor for organization risks, communicates risks to leadership and develop action plans to mitigate risks. Assists with onboarding, hiring, and training authorization team members. Participates in developing job aids, workflows and implements change management strategies. Performs other duties as assigned. Complies with all policies and standards.

Requirements

Requires a Bachelor's degree and 4+ years of related experience.
Or equivalent experience acquired through accomplishments of applicable knowledge, duties, scope and skill reflective of the level of this position.

Responsibilities

Supervises the prior authorization request process for required authorizations to ensure work queue is managed and addressed properly and timely.
Supervises day-to-day activities and provides guidance to the authorization team on documenting and resolving all authorization requests and/or issues to ensure accurate and timely documentation for services related to the members healthcare eligibility and access.
Ensures authorization team’s compliance with contract requirements, policies, procedures, and performance standards.
Monitors authorization requests inventory to ensure proper resources allocation throughout the day.
Maintains knowledge of contract requirements, policies, procedures, and performance standards.
Works with authorization team and senior management to identify opportunities for process and quality improvements within authorization request processes.
Evaluates authorization team performance and provides feedback regarding performance, goals, and career milestones.
Provides coaching and guidance to authorization team for SLAs and department productivity goals to ensure accurate and timely documentation for services and improve processing and quality of authorization requests.
Proactively monitor for organization risks, communicates risks to leadership and develop action plans to mitigate risks.
Assists with onboarding, hiring, and training authorization team members.
Participates in developing job aids, workflows and implements change management strategies.
Performs other duties as assigned.
Complies with all policies and standards.