3Y Health · 2 months ago
Prior Authorization Lead
San Francisco Office
Full-time
Onsite
Mid, Senior Level
$100K/yr - $140K/yr
5+ years exp3Y Health is building AI-driven software to empower healthcare providers by solving administrative complexities in the industry. The Prior Authorizations Lead will manage the entire prior authorization process, streamline workflows, and collaborate with various teams to enhance operational efficiency and partner experience.
Computer Software
Responsibilities
Lead the end-to-end prior authorization process, including verification, documentation, submission, and follow-up with payers
Build and optimize workflows that minimize turnaround times and maximize approval rates across multiple specialties
Partner with Product and Engineering to identify automation opportunities and develop tools that reduce manual work
Collaborate with RCM and Operations teams to ensure clean handoffs between authorizations, billing, and patient care coordination
Develop and track KPIs to monitor authorization performance, identify bottlenecks, and continuously improve process efficiency
Train and manage a growing team or vendor partners to ensure consistent execution and adherence to payer guidelines
Maintain up-to-date knowledge of payer requirements, clinical criteria, and regulatory changes that impact authorization processes
Build documentation, playbooks, and SOPs to support scaling into new states, payers, and clinical verticals
Qualification
Required
Bachelor's degree required
5–8 years of experience in healthcare operations, prior authorization management, or related RCM functions
Strong understanding of payer requirements, medical necessity documentation, and authorization workflows
Proven ability to lead cross-functional initiatives and manage complex, high-volume processes
Analytical and systems-oriented thinker with a track record of driving measurable improvements in turnaround times and accuracy
Ability to work 5 days a week in our San Francisco or New York office with a fully in-person team
Preferred
Experience with automation tools or EMR/EHR integrations a plus
Benefits
Stock options
Company
3Y Health
At 3Y, we believe clinician entrepreneurs are the future of healthcare.
51-200 employees
Funding
Current Stage
Growth StageCompany data provided by crunchbase