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Prior Authorization Manager
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Full-time
- The Manager of MGB BWH/BWF Prior Authorization Team reports to the Patient Access Services Executive Director and is responsible for the daily operations of the Prior Authorization Team. This position includes responsibilities related to the financial management, personnel management, policies and procedures, and compliance requirements for both MGB Brigham and Women’s and Faulkner hospitals.
- Provides leadership, organizational structure and management for realistic long-range planning and efficient daily operations for Mass General Brigham and Faulkner Prior Authorization and collaborates with Patient Financial Services, Denials and Appeals and Outsource Vendors for Prior Authorization.
- Works as a team with Managers of other departments to accomplish operational requirements of Prior Authorization to prevent denials, optimize financial clearance, maximize revenue recoveries for Mass General Brigham and Faulkner hospitals.
- Works with the Executive Director on revenue enhancements and process improvement projects and facilitates the resolution of complex issues impacting compliance, revenue and daily front end processes within the Mass General Brigham and Faulkner Prior Authorization Team and Denials and Appeals Departments.
- Provides review and oversight of annual operational and financial goals and objectives including development and monitoring of key performance indicators for both quality and efficiency for Mass General Brigham and Faulkner for PA, PFS, Denials and Appeals.
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