Program Manager - Prior Auth (Remote) at Availity

You are an experienced healthcare professional with a background in managing complex, multi-stakeholder implementations. You must possess deep technical knowled

Work type: remote

Location: Remote - United States

Salary: $250/hr

Type: Full-time

Summary

You are an experienced healthcare professional with a background in managing complex, multi-stakeholder implementations. You must possess deep technical knowledge of X12, FHIR, and prior authorization workflows to be considered, as sponsorship is not available for this role. **What makes it worth a look...** Availity offers a fully remote senior-level role based in the United States, though the listed $250/hour rate appears to be an error or outlier for this position. The company provides a robust benefits package including a 401k match, unlimited PTO for salaried staff, and wellness reimbursement, along with a high-visibility mandate to handle premier "white glove" client accounts. **You might be a good fit if you...** * Have direct experience with X12 and FHIR standards. * Understand the end to end prior authorization process for payers and providers. * Manage cross-functional teams across both technical and business departments. * Have worked directly with C-suite stakeholders in a client-facing delivery role.

Job Description

Availity delivers revenue cycle and related business solutions for health care professionals who want to build healthy, thriving organizations. Availity has the powerful tools, actionable insights and expansive network reach that medical businesses need to get an edge in an industry constantly redefined by change.

At Availity, we're not just another Healthcare Technology company; we're pioneers reshaping the future of healthcare! With our headquarters in vibrant Jacksonville, FL, and an exciting office in Bangalore, India, along with an exceptional remote workforce across the United States, we're a global team united by a powerful mission.

We're on a mission to bring the focus back to what truly matters - patient care. As the leading healthcare engagement platform, we're the heartbeat of an industry that impacts millions. With over 2 million providers connected to health plans, and processing over 12 billion transactions annually, our influence is continually expanding.

Join our energetic, dynamic, and forward-thinking team where your ideas are celebrated, innovation is encouraged, and every contribution counts. We're transforming the healthcare landscape, solving communication challenges, and creating connections that empower the nation's premier healthcare ecosystem.

Sponsorship, of any kind, is not available for this role.Overview of the role:

The Program Manager is responsible for leading post‑sales healthcare implementations, ensuring customers move efficiently from contract signature through delivery in a complex, fast‑paced environment. This role manages multiple concurrent implementations, coordinating cross‑functional dependencies with product, engineering, and Solutions Engineering teams while adapting to shifting timelines and capacity constraints.
The Program Manager may assist with the analysis of project, program, and operational data to align the outcome of projects with Availity strategic, product and business goals. You will determine the optimal mix of resources and sequencing of projects within their program to best achieve the company's overall goals while managing costs and client expectations. The Program Manager must have excellent communication and presentation skills and the ability to relate to customers at the project and executive level.

Sponsorship, in any form, is not available for this position.Why you want to work on this team:

• Work for a team that has high visibility across the organization

• Handle Availity’s premiere clients that receive “white glove” service

• Play an integral part of the revenue stream as new customers are implemented

• Experience managing multiple, complex implementations and strategic initiatives within the healthcare space. Healthcare background is required to be considered for the role.

• Technical acumen. The ideal candidate is familiar with X12, FHIR, and understands prior authorization workflows. Candidates without FHIR experience would not considered.

• Possess strong written and oral communication skills.

• Experience working directly with multiple levels of customers (Project Managers to C-Level Executives), this is a client facing position.

• Proven track record in managing/influencing cross functional teams (technology and business).

• Demonstrated political awareness and ability to diplomatically handle sensitive situations with internal and external customers and ability to cultivate effective, productive customer relationships and partnerships.

• Demonstrated balance of business, operational, and technical experience in customer delivery.

• An in-depth understanding of the prior authorization end to end process from providers to payers

• Leading  internal and external teams on the day-to-day oversight of project deliverables, working business and technical requirements along with a technical delivery plan, deployment plans, operational project plans, etc. 

• Managing strategic Health Plan implementations.

• Establishing and maintaining relationships with key stakeholders at multiple levels within the Health Plan.

• Preparing and presenting material associated with the implementation including  kick-off meetings, program status (including C level stakeholders), etc.

• Working cross-functionally with many internal Availity teams: product, engineering, client services, strategic account services, provider services, provider engagement and training, clinical operations, and many more.  You must have the ability to tailor communications and discussions to the applicable audiences

• Accountable to team and customer Key Performance Indicators as a measure of success.

• Traveling to the client site as needed (less than 25%)

• Availity is a certified "Great Place to Work"! Culture is important to us and there are many ways for you to make your mark here!

• We have several Culture teams, a Young Professionals Group, and various ways to engage with fellow Availity associates – if you’re near Jacksonville, we have lots of pop up lunches where lunch is provided for everyone when we can see meetings are taking place and we’ve got teams in the office.

• Availity is a culture of continuous learning. We have many resources and experts in our tech stack, our industry and your function that can help get you there too!

• We offer a competitive salary, bonus structure, generous HSA company contribution, healthcare, vision, dental benefits and a 401k match program that you can take advantage of on day one!

• We offer unlimited PTO for salaried associates + 9 paid holidays. Hourly associates start at 19 days of PTO and go up from there with all the same holiday benefits.

• Interested in wellness? We allow our associates to reimburse up to $250/year for gym memberships, participation in racing events, weight management programs, etc.

• Interested in furthering your education? We offer education reimbursement!

• Availity offers Paid Parental Leave for both moms and dads, both birth parents and adoptive parents.

• Want to work for an organization that gives back to the community? You're at the right place! Availity partners with various organizations, both locally and nationally, to raise awareness, funds and morale as our staff members volunteer their time and funds to engage the organizations campaign.

Interview process:

• Recruiter Recorded Video Pre-Screen

• Video Interview with Manager, Health Plan Delivery

• Video Interview with Solution Engineers

• Final Video with Director, Delivery Services

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