📌 About Alpaca HealthAlpaca Health enables clinicians to become entrepreneurs, starting in autism care.We help clinicians launch and scale their own clinics by providing AI-powered software, payer contracting, and full back-office infrastructure. Our goal is simple: shift power in healthcare away from large consolidated entities and back to clinicians.We've raised over $14M in funding from early-stage investors like Core Innovation Capital, Adverb Ventures, and South Park Commons, and are building for long-term category leadership. More importantly, we're serving thousands of patients, while growing 30% - 50% MoM.This role is full-time, remote, and based in the United States🎯 Role: Prior Authorizations ManagerResponsibilities:Work with our Prior Authorizations vendor to resolve complex authorization issues including coordinating with our providers, patients and payorsBe the inhouse expert for all prior authorizations and pre-certification requests and requirements for a region or set of payorsSupport the team in chasing down documentation, resolving auth rejections, and navigating payer requirementsWork with the operations team to identify bottlenecks, inefficiencies, and opportunities across the intake workflowDevelop processes and training materials for offshore team members to resolve day-to-day prior authorization issuesOwn Prior Authorization outcomes and KPIs for your region / payors🧠 Who You Are[REQUIRED] 5+ years of experience in ABA intake with a specific focus on Prior Authorizations or Insurance Certification[REQUIRED] Strong understanding of the ABA pre-certification process for Tricare East, Medicaid MCOs, BCBS State plans, Aetna, and/or CignaYou are highly organized and relentless about follow-through, nothing falls through the cracks on your watchExtreme detail orientation and ability to read complex clinical documents, payor feedback, and EHR data with regards to prior authorization workflowsYou communicate clearly and confidently with everyone from parents to clinicians to payor contactsYou are a problem-solver - you identify the issue and fix itYou are comfortable with ambiguity and can make good judgment calls in real timeYou hold yourself to a high bar while remaining approachable and supportive🚀 Why JoinThe opportunity to materially impact the health outcomes of the most vulnerable populationsOpportunity for rapid career growth as we build out a net new function at Alpaca HealthJoin one of the fastest growing healthcare startups in the world (between 30% - 50% monthly growth)Join a team of rockstar performers who are taking a new tech first approach to building a scalable digital health platform

Prior Authorization Manager

Emma

Requirements and responsibilities

Skills wanted:

Language(s) required:

Bao Van

Michael Gao

Bao Van

Michael Gao

About Alpaca Health:

www.alpacahealth.io/

Admin access needed