Supervisor - Benefits Eligibility and Authorization

Cardinal Health•CA-California-Work from Home, CA

2d•$76,700 - $98,460•Onsite

About The Position

Supervisor, Benefits Eligibility and Authorization About Navista We believe in the power of community oncology to support patients through their cancer journeys. As an oncology practice alliance comprised of more than 40 sites, Navista provides the support community practices need to fuel their growth—while maintaining their independence. What Revenue Cycle Management (RCM) contributes to Cardinal Health Practice Operations Management oversees the business and administrative operations of medical practices. The Revenue Cycle Management manages a team focused on a series of clinical and administrative processes that healthcare providers utilize to capture, bill, and collect patient service revenue. The revenue cycle shadows the entire patient care journey and begins with patient appointment scheduling and ends when the patient’s account balance is zero.

Requirements

Experience developing, monitoring, and reporting operational KPIs, productivity metrics, quality audits, and performance dashboards.
Strong analytical, problem-solving, and process improvement skills with the ability to identify trends and implement corrective actions.
Excellent leadership, coaching, performance management, and employee development skills.
Ability to effectively manage workload prioritization in a fast-paced oncology environment with competing patient care and payer deadlines.
Strong communication and relationship-building skills with physicians, clinical staff, executives, payers, and external partners.
Proficiency with electronic health records (EHRs), practice management systems, authorization platforms, Microsoft Excel, and reporting tools.
Demonstrated commitment to compliance, regulatory requirements, patient-centered care, and operational excellence.

Nice To Haves

Bachelor's degree in Healthcare Administration, Business, Nursing, or related field preferred.
Minimum five (5) years of healthcare prior authorization, financial clearance, patient access, or revenue cycle experience preferred
Minimum two (2) years of leadership, supervisory, or team lead experience in a healthcare setting preferred
Oncology, infusion, radiation oncology, specialty pharmacy, or multi-specialty authorization experience strongly preferred.
Extensive knowledge of medical oncology treatment regimens, radiation oncology services, imaging, genetic testing, surgical procedures, and specialty referrals.
Strong understanding of Medicare, Medicaid, commercial payer, HMO, IPA, and delegated authorization requirements.
Experience managing prior authorization workflows, referral management, medical necessity review, and payer compliance.
Proven ability to reduce authorization-related denials, treatment delays, and revenue risk through effective operational oversight.
Preferred certifications include CRCR, CHAM, CPAR, CPC, or other revenue cycle, reimbursement, or healthcare access certifications.

Responsibilities

Supervise and coordinate the daily activities of the oncology authorization team to ensure timely completion of authorization requests and financial clearance activities.
Monitor work queues, assign priorities, and manage staff productivity to support timely patient treatment and service scheduling.
Oversee prior authorization, referral, and medical necessity processes for medical oncology, radiation oncology, imaging, genetic testing, surgery, specialty medications, and ancillary services.
Review escalated cases, denied authorizations, urgent treatment requests, and payer issues to ensure timely resolution.
Ensure authorizations are obtained prior to service, tracked appropriately, and renewed or extended as needed to avoid treatment delays.
Collaborate with physicians, advanced practice providers, nursing, pharmacy, scheduling, and financial counseling teams to resolve authorization barriers and support patient readiness for treatment.
Conduct daily huddles, staff coaching, and workflow reviews to drive accountability, quality, and service excellence.
Monitor authorization turnaround times, aging inventories, pending requests, and high-priority patient cases to ensure departmental performance goals are met.
Maintain expertise on payer policies, medical necessity requirements, authorization guidelines, and regulatory changes impacting oncology services.
Review authorization-related denials, identify root causes, and implement corrective actions to reduce revenue leakage and prevent recurring issues.
Perform quality audits to ensure authorization accuracy, documentation compliance, and adherence to organizational policies and procedures.
Develop and maintain department standard operating procedures, training materials, and payer-specific workflows.
Generate and analyze daily, weekly, and monthly operational reports, including authorization approval rates, denial trends, productivity, and turnaround times.
Partner with Revenue Cycle, Patient Access, Managed Care, and Clinical Leadership teams to improve authorization efficiency and financial performance.
Support staff development through training, performance management, mentoring, and competency assessments.
Ensure compliance with Medicare, Medicaid, commercial payer, IPA, and other regulatory requirements governing authorization and financial clearance activities.
Serve as the primary escalation point for complex authorization issues, payer disputes, peer-to-peer reviews, and treatment-related access concerns.
Lead continuous improvement initiatives focused on reducing treatment delays, improving patient experience, increasing authorization approval rates, and minimizing preventable denials.