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knownwell · 2 days ago

Prior Authorization Team Lead

United States

Full-time

Remote

Mid, Senior Level

$27/hr - $28/hr

3+ years exp

Knownwell is a dynamic company focused on weight-inclusive healthcare for all, aiming to transform obesity care delivery. The Prior Authorization Team Lead will oversee prescription prior authorization operations, ensuring timely approvals and managing internal and external teams to enhance patient access to care.

Artificial Intelligence (AI)Health CareMedicalPrimary and Urgent Care

Responsibilities

Lead and manage prescription prior authorization operations, setting clear expectations and holding the line on accuracy, turnaround times, and approvals

Own the end-to-end PA process across intake, submission, follow-up, appeals, and resolution

Serve as the primary operational contact for the BPO partner, overseeing productivity, quality, SLA adherence, and ongoing performance optimization

Act as the escalation point for complex or high-risk cases, including denials and urgent medication needs

Ensure consistent, compliant handling of payer requirements across commercial and government plans

Monitor queue volumes, aging, approval rates, and denial trends, adjusting workflows to prevent delays and backlogs

Coach team members through live cases and real scenarios, identifying gaps and raising performance quickly

Partner with clinical, pharmacy, and patient experience teams to keep patients informed and care moving

Track performance metrics and use them to drive concrete process improvements, not passive reporting

Qualification

Prior Authorization ManagementBPO Partner ManagementGLP-1 AuthorizationPayer Rules KnowledgeEHRPA PlatformsPeople LeadershipPerformance TrackingDecision Making