Prior Authorization Analyst

Job Summary

A company is looking for a Prior Authorization Data Analyst.

Key Responsibilities

• Govern and analyze Prior Authorization processes and procedures across the enterprise
• Identify trends and opportunities for value-based initiatives and communicate findings to leadership
• Maintain and update the enterprise-wide prior authorization list and facilitate the Prior Auth Committee meetings

Required Qualifications

• Associate's degree required; Bachelor's degree preferred
• Strong proficiency in SQL and data mining (SAS)
• Certified Professional Coder (CPC) certification preferred
• 5 or more years of experience in prior authorization, utilization management, or healthcare operations
• Experience with evidence-based clinical decision support tools is desired