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About the role
- Manager of Payer Connectivity optimizing healthcare prior authorization processes. Enhancing automation and interoperability while collaborating with cross-functional teams for effective delivery.
Responsibilities
- Develop and execute strategies to enhance the automation and interoperability of prior authorization workflows across providers, vendors, and payers
- Define and maintain a payer connectivity roadmap aligned with organizational goals and report progress to executive leadership
- Collaborate with engineering, development, and product teams to integrate payer-specific requirements into EHR systems and the Waystar platform
- Drive initiatives that enable automated submission, tracking, and response handling for prior authorization requests
- Identify pain points and inefficiencies in current prior authorization processes
- Design and implement scalable, automated solutions that streamline workflows and reduce manual effort
- Act as the liaison between internal teams and external payer/provider stakeholders
- Translate payer needs and industry insights into actionable product and technical requirements
- Lead, mentor, and develop a team responsible for managing payer connectivity, requirements gathering, and validation criteria
- Ensure backlog refinement, sprint planning, and retrospectives are executed effectively
- Provide clarity of goals and equip team members with tools and knowledge for successful delivery
- Ensure all payer connectivity solutions meet regulatory and industry standards for privacy, security, and data exchange
- Monitor policy changes and adjust solutions accordingly to maintain compliance
Requirements
- Proven ability to manage cross-functional teams and lead change in a dynamic healthcare or technology environment
- Excellent verbal and written communication skills for interacting with payers, providers, and internal stakeholders at all levels
- Deep understanding of healthcare administration, payer operations, and prior authorization processes
- Familiarity with regulatory requirements (e.g., HIPAA, CMS mandates) related to data exchange
- Experience working with payer connectivity tools, healthcare interoperability standards (e.g., HL7, FHIR, X12 278), and automation technologies
- Ability to analyze complex workflows, identify improvement opportunities, and drive continuous enhancements
- Bachelor’s degree in Healthcare Administration, Information Systems, Business, or a related field (preferred)
- 5+ years of experience in healthcare operations, payer/provider connectivity, or health tech product management (preferred)
- Prior experience working with EHR platforms and healthcare IT vendors (preferred)
- Familiarity with Agile development methodologies and sprint management (preferred)
Benefits
- Competitive total rewards (base salary + bonus, if applicable)
- Customizable benefits package (3 medical plans with Health Saving Account company match)
- Generous paid time off for our non-exempt team members, starting with 3 weeks + 13 paid holidays, including 2 personal floating holidays
- Flexible time off for our exempt team members + 13 paid holidays
- Paid parental leave (including maternity + paternity leave)
- Education assistance opportunities and free LinkedIn Learning access
- Free mental health and family planning programs, including adoption assistance and fertility support
- 401(K) program with company match
- Pet insurance
- Employee resource groups
Job title
Job type
Experience level
Salary
Not specified
Degree requirement
Location requirements
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