Manager, Part C – Authorizations
Habitat Health
full-time
Posted on:
Location Type: Remote
Location: United States
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Salary
💰 $119,000 - $134,000 per year
About the role
- Oversees day-to-day adjudication operations, ensuring a controlled, disciplined, regulatorily compliant and exceptionally reliable operational environment.
- Responsible for establishing and maintaining reports to support the efficacy of each service authorizations process.
- Review and monitor encounter data submissions for accuracy, maintaining documentation and troubleshooting processes.
- Engages with Enrollment & Eligibility to resolve data discrepancies impacting member benefits or provider assignments.
- Conduct retrospective reviews and maintains reporting evaluating the accuracy, timeliness, and effectiveness of service authorization processes.
- Monitors daily, weekly, and monthly inventory to anticipate risk and maintain a stable production environment.
Requirements
- 7+ years of experience in health insurance operations, including team leadership and direct supervisory experience.
- Demonstrated expertise in claims processing and utilization management
- Background in capitated health plan financials; PACE experience strongly preferred.
- Strong customer service orientation and ability to handle confidential information.
- Excellent verbal and written communication skills.
- Bachelor’s degree in healthcare, finance, or related field required; Master’s degree preferred.
- Proficiency in Microsoft Office Suite (Word, Excel, PowerPoint).
Benefits
- health insurance
- life insurance
- participation in the company’s equity program
- paid time off, including vacation and sick leave
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
claims processingutilization managementdata analysisreportingtroubleshootingservice authorizationencounter data submissionfinancial analysiscapitated health planPACE experience
Soft Skills
team leadershipsupervisory experiencecustomer service orientationconfidential information handlingverbal communicationwritten communicationproblem-solvingattention to detailorganizational skillsrisk management