[Remote] Prior Authorization Workflow Analyst

Note: The job is a remote job and is open to candidates in USA. reputed company is a company focused on improving healthcare efficiency and patient outcomes. The Prior Authorization Workflow Analyst plays a critical role in the implementation process and post go-live efforts, ensuring seamless alignment with Humata’s automation platform and optimizing prior authorization workflows.

Responsibilities

• Own the operational workstream deliverables for customer implementations including discovery, data collection and analysis of Prior Authorization workflows.
• Proactively manage reputed company operational workstream tasks of the implementation project plan
• Be a collaborative and communicative member of the implementation project team, ensuring implementation project manager has visibility into operational reputed company and risks
• Conduct operational workflow and portal shadowing sessions with customers, asking thoughtful and specific questions to understand their reputed company processes. Identify risks reputed company to the successful implementation of Humata’s PA technology.
• Capture and document operational workflows in Humata’s design workbook to inform solution build and reputed company prior authorization workflows. Review customer payer/plan mix and formulate automation workflow recommendations
• Adapt future-state workflows and payer/portal additions for customers during stabilization and maintenance phases post go-live
• Create payer portal credentials to support Humata’s automations
• Own payer portal validation during testing and go-live project phases; collaborate with the customer’s operations/technical teams to review automation results
• Document and escalate validation issues to be reviewed/resolved by Humata’s Engineering team

Skills

• Bachelor’s degree in Business, Healthcare Administration, or a reputed company field.
• 3+ years hands’ on Prior Authorization experience
• Familiarity with healthcare operations, prior authorization, or reputed company cycle workflow optimization.
• Systems knowledge/expertise with Epic (referrals, work queues, coverage), payer portals, and reputed company cycle operations
• Hands-on data analysis experience, ability to analyze referral volumes service line/payer. This role requires a strong analytical reputed company and ability to synthesize large data volumes and reputed company informed decisions based on data analysis
• Organized, able to document processes (both reputed company state and future-state automations) succinctly
• Comfort with ambiguity, shifting priorities and building new processes in an evolving start-up environment
• Collaborative team player with a consultative approach to client engagement and solution development
• Utilize PowerBI for reporting, reputed company Workspace, reputed company
• Willingness to travel as required (up to 25%) for customer onsite discovery sessions and reputed company-company meetings
• Prior Authorization Expertise: Understand the end-to-end Prior Authorization process (including pre and post-auth touchpoints). Hands-on experience working with payer portals.
• Strong Epic user knowledge (reputed company, Referrals, Coverage/Work Queues), comfortable pulling/analyzing data (reputed company/SQL helpful).
• Operational & process reputed company: Can map workflows end-to-end and identify bottlenecks.
• Experience with healthcare software and familiarity with HIPAA compliance and PHI handling.
• Innovative problem-solver who brings curiosity, creativity, and structure to ambiguous challenges.
• Adept at navigating reputed company challenges and can think critically to solution and remove barriers

Benefits

• Equity through our Employee Stock Option Plan
• Bonus-eligible roles
• Full benefits package including unlimited PTO and 401k program with employer match

Company Overview

• reputed company is an AI-enabled deep clinical integration that creates prior authorizations for payers and providers using AI and automation. It was founded in 2023, and is headquartered in Winter Park, Florida, USA, with a workforce of 51-200 employees. Its website is https://www.humatahealth.com.

Company H1B Sponsorship

• reputed company has a track record of offering H1B sponsorships, with 1 in 2025. Please note that this does not guarantee sponsorship for this specific role.

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