Supervisor – Benefits Eligibility and Authorization

🔥 10 minutes ago

🏄 California – Remote

🏄 California – Remote

💵 $76.7k - $98.5k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 0%

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Cardinal Health

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1971

📦 Logistics

🏭 Manufacturing

🏥 Healthcare

💰 $78M Post-IPO Debt on 2006-08

Logistics • Manufacturing • Healthcare

Cardinal Health is a global healthcare services and products company. It provides a comprehensive range of healthcare services, including medical supply distribution, pharmaceutical distribution, and logistics solutions to various healthcare facilities such as hospitals, community health centers, and ambulatory surgery centers. Additionally, Cardinal Health offers a variety of medical products and pharmaceutical services. The company also focuses on innovative solutions to enhance healthcare delivery, through services like patient support, pharmacy management, and advanced therapy solutions. Cardinal Health is committed to supporting healthcare providers in delivering quality patient care while optimizing operational efficiency.

📋 Description

• Supervise and coordinate the daily activities of the oncology authorization team • Monitor work queues, assign priorities, and manage staff productivity • Oversee prior authorization, referral, and medical necessity processes across oncology and ancillary services • Review escalated cases, denied authorizations, urgent treatment requests, and payer issues • Ensure authorizations are obtained, tracked, renewed, or extended to avoid treatment delays • Collaborate with physicians, advanced practice providers, nursing, pharmacy, scheduling, and financial counseling teams • Conduct daily huddles, staff coaching, and workflow reviews • Monitor authorization turnaround times, aging inventories, pending requests, and high-priority cases • Maintain expertise on payer policies, medical necessity requirements, authorization guidelines, and regulatory changes • Review authorization-related denials, identify root causes, and implement corrective actions • Perform quality audits for authorization accuracy, documentation compliance, and policy adherence • Develop and maintain standard operating procedures, training materials, and payer-specific workflows • Generate and analyze operational reports on approval rates, denial trends, productivity, and turnaround times • Partner with Revenue Cycle, Patient Access, Managed Care, and Clinical Leadership teams • Support staff development through training, performance management, mentoring, and competency assessments • Ensure compliance with Medicare, Medicaid, commercial payer, IPA, and other regulatory requirements • Serve as the primary escalation point for complex authorization issues, payer disputes, peer-to-peer reviews, and treatment access concerns • Lead continuous improvement initiatives to reduce treatment delays, improve patient experience, increase approval rates, and minimize preventable denials

🎯 Requirements

• Bachelor's degree in Healthcare Administration, Business, Nursing, or related field preferred • Minimum five (5) years of healthcare prior authorization, financial clearance, patient access, or revenue cycle experience preferred • Minimum two (2) years of leadership, supervisory, or team lead experience in a healthcare setting preferred • Oncology, infusion, radiation oncology, specialty pharmacy, or multi-specialty authorization experience strongly preferred • Extensive knowledge of medical oncology treatment regimens, radiation oncology services, imaging, genetic testing, surgical procedures, and specialty referrals • Strong understanding of Medicare, Medicaid, commercial payer, HMO, IPA, and delegated authorization requirements • Experience managing prior authorization workflows, referral management, medical necessity review, and payer compliance • Proven ability to reduce authorization-related denials, treatment delays, and revenue risk through effective operational oversight • Experience developing, monitoring, and reporting operational KPIs, productivity metrics, quality audits, and performance dashboards • Strong analytical, problem-solving, and process improvement skills • Excellent leadership, coaching, performance management, and employee development skills • Ability to manage workload prioritization in a fast-paced oncology environment with competing patient care and payer deadlines • Strong communication and relationship-building skills with physicians, clinical staff, executives, payers, and external partners • Proficiency with electronic health records (EHRs), practice management systems, authorization platforms, Microsoft Excel, and reporting tools • Demonstrated commitment to compliance, regulatory requirements, patient-centered care, and operational excellence • Preferred certifications include CRCR, CHAM, CPAR, CPC, or other revenue cycle, reimbursement, or healthcare access certifications

🏖️ Benefits

• Medical, dental and vision coverage • Paid time off plan • Health savings account (HSA) • 401k savings plan • Access to wages before pay day with myFlexPay • Flexible spending accounts (FSAs) • Short- and long-term disability coverage • Work-Life resources • Paid parental leave • Healthy lifestyle programs