Prior Authorization Product Analyst jobs in United States
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Oracle · 3 months ago

Prior Authorization Product Analyst

positionUnited States
timeFull-time
remoteRemote
seniorityMid Level
date3+ years exp

Oracle is a leading enterprise software company focused on innovative solutions in healthcare. They are seeking a Prior Authorization Product Analyst to enhance the prior authorization features of their Clinical AI Assistant, aiming to improve physician efficiency and patient experiences while alleviating burnout for healthcare workers.

Data GovernanceData ManagementEnterprise SoftwareInformation TechnologySaaSSoftware
badNo H1Bnote

Responsibilities

Drive the features and capabilities of the prior authorization aspect of the Clinical AI Assistant
Contribute to products geared toward physician efficiency and clinical assistance
Work with cross-functional teams to create a product that ensures accurate, compliant, and scalable automation for providers, payers, and patients

Qualification

Prior authorization managementHealthcare domain knowledgeRegulatory complianceAnalytical skillsCommunication skillsHealthcare AdministrationNursingHealth Information ManagementPublic HealthBusiness (healthcare focus)CPAS certificationCPC certificationCMAA certificationCRCR certificationCHAA certificationRHIT certificationMedical BillingCoding Certification

Required

Associate's or Bachelor's Degree or equivalent experience in Healthcare Administration, Nursing, Health Information Management, Public Health, or Business (with healthcare focus)
Minimum of 3+ years in healthcare operations, specifically in prior authorization management in a hospital or physician practice
Direct experience with managing prior authorization requests end-to-end
Direct experience with communicating with insurance companies and clinical staff
Direct experience with navigating denials and appeals
Strong understanding of prior authorization processes, payer guidelines, medical necessity criteria, and regulatory compliance (HIPAA, CMS, ACA, etc.)
Strong analytical skills with the ability to identify process inefficiencies and design practical solutions
Excellent verbal and written communication skills
Ability to explain complex technical concepts to non-technical stakeholders and collaborate effectively with cross-functional teams

Preferred

Certified Prior Authorization Specialist (CPAS)
Certified Professional Coder (CPC)
Certified Medical Administrative Assistant (CMAA)
Certified Revenue Cycle Representative (CRCR)
Certified Healthcare Access Associate (CHAA)
Registered Health Information Technician (RHIT)
Medical Billing and Coding Certification

Company

Oracle

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Oracle is an integrated cloud application and platform services that sells a range of enterprise information technology solutions.
dateFounded in 1977
location
Austin, Texas, USA
people-size10001+ employees
web-link
https://www.oracle.com/

Funding

Current Stage
Public Company
Total Funding
$25.75B
Key Investors
Sequoia Capital
2025-09-24Post Ipo Debt· $18B
2025-02-03Post Ipo Debt· $7.75B
1986-03-12IPO

Leadership Team

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Esteban Rubens
Healthcare Field CTO
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Gerard Warrens
Field CTO, Business Strategy and Transformative Technologies
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