Program Manager, Prior Authorizations

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 3 million providers connected to health plans, and processing over 19 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

To be qualified for this position you:

• 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.

• 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.

• Proven ability to independently assume ownership of active projects, establish priorities, and successfully deliver outcomes with minimal oversight.

• Ability to quickly evaluate project progress, identify gaps, align stakeholders, and drive initiatives to completion with limited direction.

You will set yourself apart with:

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

• Familiarity with APIs and FHIR

You will be:

• 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 culture and benefits:

• 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.

Next steps:
After you apply, you will receive text/email messages thanking you for applying and then you will continue to receive more text/email messages alerting you as to where you are in the recruitment process.

Interview process:

• Recruiter Recorded Video Pre-Screen

• Video Interview with Manager, Health Plan Delivery

• Video Interview with Solution Engineer

• Final Video with Director, Delivery Services

Video Camera Usage:

Availity fosters a collaborative and open culture where communication and engagement are central to our success. As a remote first company, we are also camera-first and provide all associates with camera/video capability to simulate the office environment. If you are not able to use your camera for all virtual meetings, you should not apply for this role.

Having cameras on helps create a more connected, interactive, and productive environment, allowing teams to communicate more effectively and build stronger working relationships. The usage of cameras also enhances security and protects sensitive company information. Video participation is required to ensure that only authorized personnel are present in meetings and to prevent unauthorized access, data breaches, preventing social engineering, or the sharing of confidential information with non-participants.

Disclaimers:

Availity is an equal opportunity employer and makes decisions in employment matters without regard to race, religious creed, color, age, sex, sexual orientation, gender identity, gender expression, genetic information, national origin, religion, marital status, medical condition, disability, military service, pregnancy, childbirth and related medical conditions, or any other classification protected by federal, state, and local laws and ordinances.

Availity is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

NOTICE: Federal law requires all employers to verify the identity and employment eligibility of all persons hired to work in the United States. When required by state law or federal regulation, Availity uses I-9, Employment Eligibility Verification in conjunction with E-Verify to determine employment eligibility. Learn more about E-Verify at http://www.dhs.gov/e-verify.

Click the links below to view Federal Employment Notices.

Family & Medical Leave ActEqual Employment Law PosterPay TransparencyEmployee Polygraph Protection ActIER Right to Work PosterImportant Notice about Employee Rights to Organize and Bargain Collectively with Their Employers

Originally posted on Himalayas