Prior Authorization Manager

The Opportunity:

As we continue to expand and transform the primary care experience, we’re looking for energetic and passionate leaders to manage the people, processes, and technology that make One Medical unique. As a Centralized Services Operations Manager, you’ll be responsible for meeting One Medical patient promises of outstanding quality of care, access, and truly patient-centered experiences at an affordable cost. You’ll execute our mission of delivering high-quality care and service using The One Medical Performance System (TOPS). Specifically, you’ll manage the centralized services team members and lead our operations to ensure One Medical is a great experience for both patients and team members. 

You are a strong people leader and innovative problem-solver, who is driven to create efficient workflows and cultivate cohesive teams. You are self-aware, a continual learner, and focus on the big picture. You have mastered the art of customer-service, administrative work and motivating a team or peers, especially through times of change.  You are currently looking for your next opportunity that has an emphasis on delivering results, driving engagement and all things people management at an organization that is transforming healthcare. If this sounds like you, we would love to connect. 

In order to be successful in this role, you’ll need to be comfortable managing a team focused on completing complex authorizations (think MRIs, complex imaging, specialist visits, direct testing and DME requests,) resolving challenging investigations, and consistently performing to or above expectations as outlined by your senior leader. 

What You'll Likely Work On:

• Support the management of the day to day operations of our inbound and outbound patient support center

• Model the ideal team member experience through excellent on-boarding, training, performance feedback, skills coaching, learning opportunities and engaged career development

• Prepares performance reports by collecting and analyzing centralized support specialists data for coaching and feedback. (a team of 15+ support services specialists)

• Audit interactions for quality, compliance and present solutions to enhance patient interactions with our central teams

• Lead team meetings, deliver information and drive KPI’s to ensure patient satisfaction and access to care at all times (CSAT/NPS)

• Assist with the development of weekly, monthly and quarterly goals and action plans

• Partners with Leadership to help determine operational center strategies by evaluating team results and objectives.

• Maintains and improves our operations by monitoring system performance and identifying and resolving problems that arise.

• Ensure patients have an amazing experience though timely access to the care they need (pre- and post-visit administrative tasks, messages, and calls) and provide solutions to issues with minimal waste and friction

• Build an engaged team leveraging CICARE (a framework containing the key elements of a great interaction and effective communication that we use with patients and each other), Active Daily Management, and Lean principles to meet patient and team experience goals

What you’ll need:

• 5+ years relevant experience managing high-performing teams in healthcare setting, with at least 2 years managing customer or patient facing support teams in a high-volume contact center setting

• Strong written and verbal communication skills 

• Ability to remain calm and in control in all situations to help resolve patient issue with little to no friction

• Advanced customer/patient focus and service skills

• Proven ability to foster strong, collaborative team-dynamics that ensure a supportive and engaged team culture

• Experience developing talent through mentorship and coaching, consistent feedback, goal setting and accountability   

• Proven track record of leading successful change management and process improvement efforts

• Experience in healthcare, particularly in collaboration with clinicians, is highly desirable

• Excellent understanding of technology, software and tools along with experience with RingCentral / Nice-InContact a plus

• Familiarity with G Suite and Electronic Health Record systems are a plus

• Flexibility with your schedule as we provide round the clock care for our patients

Benefits designed to aid your health and wellness:

Taking care of you today

• Employee Assistance Program - Free confidential advice for team members who need help with stress, anxiety, financial planning, and legal issues

• Competitive Medical, Dental, and Vision plans

• Free One Medical memberships for yourself, your friends and family

• Pre-Tax commuter benefits

• PTO cash outs - Option to cash out up to 40 accrued hours per year

Protecting your future for you and your family

• 401K match

• Credit towards emergency childcare

• Extra contributions toward maternity and paternity leave

• Paid Life Insurance - One Medical pays 100% of the cost of Basic Life Insurance

• Disability insurance - One Medical pays 100% of the cost of Short Term and Long Term Disability Insurance

This is a full-time salaried position located in Tempe, AZ. The schedule for this role is 8am to 5pm Arizona time and could include weekends. 

INDOPS1