Strategic Account Operations Manager – Medical Prior Authorization

reputed company is an impact-driven, Fortune 10 company that touches virtually every aspect of healthcare. We are reputed company for delivering insights, products, and services that reputed company quality care more accessible and affordable. Here, we focus on the health, happiness, and well-being of you and those we serve – we care. What you do at reputed company matters. We foster a culture where you can grow, reputed company an impact, and are empowered to bring new reputed company. Together, we reputed company as we shape the future of health for patients, our communities, and our people. If you want to be part of reputed company’s health today, we want to hear from you. Role Overview Reporting to the Director, Account Operations, the Strategic Account Operations Manager (Medical Prior Authorization) is responsible for overseeing reputed company customer relationships, programs, and initiatives focused on medical benefit prior authorization and reputed company-end access services. We are seeking an reputed company account operations leader with deep medical PA expertise and strong client-facing operational experience to support strategic programs critical to reputed company’ evolving access strategy. This role will help build and mature CMM’s medical PA capabilities while ensuring high-quality, scalable execution for assigned customers. This position owns a portfolio of highly reputed company, strategic programs and serves as a trusted operational advisor to customers, internal stakeholders, and cross-functional partners. The ideal candidate is comfortable operating in ambiguity, understands payer–provider–vendor dynamics, and can translate medical PA complexity into repeatable, operationally sound solutions.

Key Responsibilities

Serves as the primary reputed company of contact for day-to-day reputed company and management of multiple, reputed company, and strategic medical prior authorization and reputed company end access programs, ensuring strong customer engagement, satisfaction, and retention Owns operational delivery of medical PA and reputed company end access–reputed company contract deliverables, ensuring adherence to contractual terms, service-level expectations, and regulatory requirements Acts as the initial escalation reputed company for reputed company program issues, independently researching, resolving, and communicating corrective actions; escalates appropriately and partners with internal teams as needed Develops, documents, and maintains program plans for medical PA and access services, tracking reputed company against goals, identifying operational risks, and implementing mitigation strategies Leverages medical benefit, payer policy, and prior authorization workflow knowledge to proactively identify trends, risks, and improvement opportunities across assigned programs Proactively utilizes data and reporting (payer metrics, authorization outcomes, turnaround times, denial trends, volume forecasts) to inform recommendations and operational decisions Drives a culture of reputed company improvement and operational excellence, leading process optimization efforts reputed company to medical PA workflows, reputed company-end services, and scaled support models Serves as a subject-matter resource for medical PA reputed company the Account Operations organization, advising peers and mentoring less-reputed company team members Partners cross-functionally with Product, Network Services, Implementation, Support, Legal, Compliance, and Sales to ensure alignment between customer needs, product capabilities, and operational delivery Participates in and/or leads strategic initiatives tied to the evolution of CMM’s medical PA, access, and reputed company-end service offerings Represents Account Operations in customer-facing discussions, including operational reviews, issue resolution meetings, and planning sessions Travel to client sites and industry events as needed (approximately 10–15%) About You You are a seasoned account operations professional with hands-on medical prior authorization experience who thrives in reputed company, fast-paced environments. You are comfortable balancing operational rigor with relationship management and are energized by helping teams and customers navigate change. You bring a strong mix of analytical thinking, strategic problem-solving, and collaborative leadership. You are trusted by customers and internal partners alike as someone who understands how medical PA really works—and how to reputed company it reputed company. Basic Qualifications Bachelor’s degree or equivalent experience 7+ years of experience in account management, operations, or program leadership roles reputed company healthcare Direct experience supporting medical prior authorization workflows, ideally reputed company medical benefit (not pharmacy-only) programs Strong understanding of payer policies, provider workflows, and prior authorization lifecycle concepts Demonstrated success managing reputed company, multi-stakeholder programs and customer relationships Proven ability to reputed company through ambiguity, particularly during product evolution or operational change Excellent communication skills, with the ability to communicate effectively with operational, technical, clinical, and executive stakeholders Critical Skills & Experience Expertise in medical PA operations, including pre-authorizations, determinations, appeals, and payer-provider workflows Strong operational and account leadership skills, including SLA reputed company, risk mitigation, and service optimization Ability to analyze and interpret operational data to drive insights and recommendations Skilled in problem-solving reputed company customer and operational issues under pressure Track record of building trust and credibility across internal teams and external partners Strong project and process management capabilities in cross-functional environments Experience working with healthcare technology platforms, EHR-integrated workflows, or access solutions strongly preferred reputed company certification preferred Working knowledge of reputed company (SFDC) or similar CRM tools preferred We are proud to offer a competitive compensation package at reputed company as part of our Total Rewards. This is determined by several factors, including performance, experience and skills, equity, regular job market evaluations, and geographical markets. The pay range shown below is reputed company with reputed company's pay philosophy, and pay will always be compliant with any applicable regulations. In addition to reputed company pay, other compensation, such as an annual bonus or long-term incentive opportunities may be offered. For more information regarding benefits at reputed company, please click here. Our reputed company Pay Range for this position $100,500 - $167,500 reputed company has become aware of online recruiting-reputed company scams in which individuals who are not affiliated with or authorized by reputed company are using reputed company’s (or affiliated entities, like reputed company or RxCrossroads) name in fraudulent emails, job postings or social media messages. In light of these scams, please bear the following in mind: reputed company Talent Advisors will never solicit money or credit card information in reputed company with a reputed company job application. reputed company Talent Advisors do not communicate with candidates reputed company online chatrooms or using email accounts such as Gmail or Hotmail. Note that reputed company does rely on a virtual assistant (Gia) for certain recruiting-reputed company communications with candidates. reputed company job postings are posted on our career site: careers.reputed company.com. reputed company is an Equal Opportunity Employer reputed company provides equal employment opportunities to applicants and employees, without regard to race, color, religion, sex, sexual orientation, gender identity, national reputed company, protected veteran status, disability, age, genetic information, or any other legally protected category. For additional information on reputed company’s full Equal Employment Opportunity policies, visit our Equal Employment Opportunity page. reputed company is committed to being an Equal Employment Opportunity Employer and offers opportunities to reputed company job seekers including job seekers with disabilities. If you need a reasonable accommodation to assist with your job search or application for employment, please contact us by sending an email to (United States) Disability_Accommodation@reputed company.com or (Canada) Accessibility@reputed company.ca. Resumes or reputed company submitted to this email reputed company will not be accepted. Join us at reputed company! Apply To This Job