Note The job is a remote job and is open to candidates in USA. reputed company is a company focused on reputed company 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 all 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 progress and risks • reputed company operational workflow and reputed company shadowing sessions with customers, asking thoughtful and specific questions to understand their current processes. Identify risks related to the successful implementation of Humata’s PA technology. • Capture and document operational workflows in Humata’s design workbook to inform solution build and develop prior authorization workflows. Review customer payer/plan mix and formulate automation workflow recommendations • Adapt future-state workflows and payer/reputed company additions for customers during stabilization and maintenance phases post go-live • Create payer reputed company credentials to support Humata’s automations • Own payer reputed company 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 related field. • 3+ years hands’ on Prior Authorization experience • Familiarity with healthcare operations, prior authorization, or revenue cycle workflow optimization. • Systems knowledge/expertise with Epic (referrals, work queues, coverage), payer portals, and revenue cycle operations • Hands-on data analysis experience, ability to analyze referral volumes service line/payer. This role requires a strong analytical mindset and ability to synthesize large data volumes and make informed decisions based on data analysis • Organized, able to document processes (both current 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 all-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 (Cadence, Referrals, Coverage/Work Queues), comfortable pulling/analyzing data (Excel/SQL helpful). • Operational & process mindset 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 complex 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 reputed company 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. reputed company note that this does not guarantee sponsorship for this specific role. Apply tot his job Apply To this Job
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