Executive Lead

PRIAevents

Executive Lead Patient Access Specialists managing a team and overseeing authorization processes in healthcare. Building collaborative reporting systems and ensuring compliance with healthcare regulations.

Posted 7/28/2026full-timeRemote • Connecticut • 🇺🇸 United StatesSeniorWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in healthcare authorization processes, including benefits verification, prior authorization, and compliance with regulations. Proven leadership in managing teams, analyzing data, and enhancing operational efficiencies within patient access programs.

Highest-signal resume keywords

Healthcare Authorization ExperienceLeadership SkillsData AnalysisInsurance Processes KnowledgeRegulatory Compliance

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Patient Access ManagementData EntryMedical TerminologyClinical Data AnalysisPrior Authorization SubmissionsPayer DiscoveryKPI ManagementCase AuditingSOP ComplianceInsurance Policy Review

Soft Skills

Analytical SkillsProblem-Solving SkillsCommunication SkillsInterpersonal SkillsMentoring Skills

Tools & Technologies

Salesforce PlatformDatabase Management Systems

Industry Keywords

Healthcare RegulationsMedical Necessity CriteriaPatient Access SpecialistsStandard Operating ProceduresExecutive Leadership

About the role

Key responsibilities & impact

Lead and manage a team of patient access specialists to achieve departmental goals
Monitor and analyze data within the salesforce platform to identify areas for improvement and efficiency
Responsible for teams KPIs
Train and mentor new patient access specialists
Audit a select number of cases per program as directed by the Director, Patient Access
Work closely with other Executive Leads and the Director, Patient Access to improve/enhance operations best practices
Maintain open communication with each program assigned Strategic Account Manager and work in conjunction with them on, weekly program reviews, calls, frequent questions or concerns regarding the program
Escalate issues to the program Strategic Account Managers as needed
Manage a case load for an assigned program
Data entry and review of new patient cases into system database
Communicate with physician’s office and their staff regularly
Maintain accurate and up-to-date records within the salesforce platform to ensure accurate reporting to clients
Complete full patient access process as outlined by program SOP including but not limited to: Analyze and interpret patient clinical data, clinical notes and files to determine medical necessity criteria is met specific to each payer policy
Review multiple insurance policies to define medical necessity criteria to support medical device/procedure(s)
Benefits verification and payer discovery
Prior Authorization/ Pre-service review submissions, pre and post service appeal submissions
Ensure all documents developed to support an appeal are accurate, consistent, up to date, and in compliance with applicable Standard Operating Procedures, guidelines, and regulations
Ensure compliance with all regulatory and company policies

Requirements

What you’ll need

College degree preferred but will substitute for applicable work experience
Minimum of 5 years of experience in healthcare authorization, with at least 2 years in a supervisory role
In-depth knowledge of insurance processes, medical terminology, and healthcare regulations
Strong leadership, analytical, and problem-solving skills
Excellent communication and interpersonal skills

Benefits

Comp & perks

Health insurance
Retirement plans
Paid time off
Flexible work arrangements
Professional development