Overview
$DOE
Full Time
Accepts corp to corp applications
Contract - W2
Contract - Independent
Contract - 6
100% Travel
Skills
Life Sciences
Pre-Authorization
Job Details
Job Summary (List Format):
- Serve as a subject matter expert in pre-authorization (pre-auth) processes within the life sciences and healthcare industry.
- Advise pharmaceutical, biotech, and med-tech clients on transforming pre-auth workflows to improve speed, compliance, and patient experience.
- Analyze current business processes, identify gaps, and design improved operating models for pre-authorization.
- Collaborate with technology teams to design and implement digital and AI-based pre-auth solutions, including real-time benefit checks and EMR/EHR interoperability.
- Ensure solutions comply with CMS, FDA, and international regulations regarding pre-auth, patient safety, and access.
- Work closely with product managers, architects, and delivery teams to align business needs with technical solutions.
- Conduct stakeholder workshops to gather requirements, define KPIs, and build consensus on pre-auth initiatives.
- Contribute to thought leadership by developing white papers, points of view, and delivering webinars on pre-auth innovation and trends.
- Serve as a subject matter expert in pre-authorization (pre-auth) processes within the life sciences and healthcare industry.
- Advise pharmaceutical, biotech, and med-tech clients on transforming pre-auth workflows to improve speed, compliance, and patient experience.
- Analyze current business processes, identify gaps, and design improved operating models for pre-authorization.
- Collaborate with technology teams to design and implement digital and AI-based pre-auth solutions, including real-time benefit checks and EMR/EHR interoperability.
- Ensure solutions comply with CMS, FDA, and international regulations regarding pre-auth, patient safety, and access.
- Work closely with product managers, architects, and delivery teams to align business needs with technical solutions.
- Conduct stakeholder workshops to gather requirements, define KPIs, and build consensus on pre-auth initiatives.
- Contribute to thought leadership by developing white papers, points of view, and delivering webinars on pre-auth innovation and trends.
- Leverage 10 12 years of experience in life sciences, healthcare, or payer/provider domains, with specific expertise in pre-authorization or utilization management.
- Demonstrate strong knowledge of prior authorization workflows, interoperability standards, clinical guidelines, and patient access challenges.
- Utilize hands-on experience with provider-side systems such as EHR, claims processing, and benefit management.
- Apply excellent consulting, business analysis, communication, and stakeholder management skills.
- Preferred: Experience with CMS interoperability mandates, knowledge of the life sciences value chain, exposure to AI/ML solutions in utilization management, and advanced degrees (MBA, Life Sciences, Healthcare Management, or Pharmacy).
Employers have access to artificial intelligence language tools (“AI”) that help generate and enhance job descriptions and AI may have been used to create this description. The position description has been reviewed for accuracy and Dice believes it to correctly reflect the job opportunity.