Position Summary
The Director of Prior Authorization oversees non-clinical prior authorization staff, primarily coordinators, responsible for intake and review of pre-certification referrals. This role ensures quality, cost-effective utilization management and strict adherence to UM policies and procedures across affiliated medical groups. This is an ON-SITE,Full-time permanenet position located in West Hills, California.

Key Responsibilities

• Lead, coordinate, and manage prior authorization staff and daily operations
• Develop and maintain efficient workflows to meet compliance, timeliness, and customer service KPIs
• Support Medical Director program goals and organizational UM objectives
• Develop, refine, and implement utilization management policies and procedures aligned with industry standards and current literature
• Collaborate with medical leadership to interpret and administer applicable regulat...