St. Luke's Health System · 15 hours ago
Specialty Financial Clearance Specialist Lead - 150558
Boise, ID
Full-time
Onsite
Mid, Senior Level
3+ years expSt. Luke's Health System is committed to fostering a workplace culture that values diversity and promotes collaboration. The Specialty Financial Clearance Specialist Lead serves as the subject matter expert for securing prior authorizations for complex oncology treatments while providing leadership and training to optimize authorization workflows.
Health CareHospitalNon ProfitPrimary and Urgent Care
Responsibilities
Serves as the lead resource and oversees daily barriers for the oncology authorization team
Content expert in securing prior authorizations for high-dollar and complex oncology treatments, including chemotherapy, immunotherapy, radiation, gene therapy, stem cell transplants, targeted radiation therapies, specialty labs, and oncology procedures
Oversees daily authorization workflows, ensuring timely and accurate submissions, tracking, and follow-ups to minimize delays in patient care
Develops and delivers training programs for new and existing staff, ensuring proficiency in oncology authorization processes, medical necessity guidelines, and payer-specific requirements
Identifies trends in payer policies and authorization denials, proactively working with leadership to implement process improvements and best practices
Collaborates with providers, pharmacy teams, clinical documentation specialists, coders, and insurance carriers to resolve complex authorization issues and appeals, including coordination of peer-to-peer reviews and external reviews when necessary
Advocates for patients by assisting in securing financial assistance, providing education on insurance coverage, out-of-pocket costs, and alternative funding options
Leads initiatives to improve authorization turnaround times, reduce denials, and enhance communication between stakeholders, ensuring compliance with insurance guidelines, HIPAA, and CMS regulations
Stays current on evolving oncology treatments, insurance policies, and medical necessity requirements, disseminating critical updates to the team and clinical stakeholders
Serve as SME & at times carries an authorization workload
Other duties and responsibilities as assigned
Qualification
Required
Education: High school diploma or equivalent
Experience: 3 years relevant experience
Benefits
Robust benefits package
Competitive salary
Retirement plans
Medical, dental, and vision offerings
On-site massages
On-site counseling via our Employee Assistance Program
Access to the Personify Health Wellness tool
Formal training and career development offerings
Company
St. Luke's Health System
St. Luke's Health System is a healthcare facility offering internal medicine and urgent care services.
10001+ employees
H1B Sponsorship
St. Luke's Health System has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (4)
2024 (9)
2023 (7)
2022 (1)
2021 (7)
2020 (3)
Funding
Current Stage
Late StageLeadership Team
Kate Fowler, FACHE, CPA
SVP, Chief Financial Officer
Dani Jones, M.Coun
Chief Operating Officer, Health Partners
Recent News
HealthCareIT News
2025-11-21
Company data provided by crunchbase