Prior Authorization Manager

Alpaca Health

. Work with the Prior Authorizations vendor to resolve complex authorization issues .

Posted 11/2/2026full-timeRemote • New York • United StatesMid-LevelSeniorWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in Prior Authorizations and Insurance Certification processes, particularly within ABA intake, while effectively coordinating with providers, patients, and payors to resolve complex authorization issues. Strong organizational skills and attention to detail are essential for managing workflows and developing training materials for team members.

Highest-signal resume keywords

Prior Authorizations ExpertiseABA Pre-Certification ProcessKPI ManagementClear CommunicationProblem-Solving Ability

ATS Keywords

Tailor your resume

Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills

Prior AuthorizationsInsurance CertificationABA IntakeKPI ManagementEHR Data AnalysisDocumentation ReviewWorkflow OptimizationTraining DevelopmentComplex Clinical Document ReadingAuthorization Rejection Resolution

Soft Skills

Highly OrganizedAttention to DetailFollow-ThroughComfort with AmbiguityReal-Time Judgment

Industry Keywords

Tricare EastMedicaid MCOsBCBS State PlansAetnaCigna

About the role

Key responsibilities & impact

Work with the Prior Authorizations vendor to resolve complex authorization issues
Coordinate with providers, patients, and payors
Serve as the in-house expert for prior authorizations and pre-certification requests and requirements for a region or set of payors
Support the team in obtaining documentation, resolving authorization rejections, and navigating payer requirements
Work with the operations team to identify bottlenecks, inefficiencies, and opportunities in the intake workflow
Develop processes and training materials for offshore team members handling day-to-day prior authorization issues
Own Prior Authorization outcomes and KPIs for the assigned region or payors

Requirements

What you’ll need

5+ years of experience in ABA intake with a specific focus on Prior Authorizations or Insurance Certification
Strong understanding of the ABA pre-certification process for Tricare East, Medicaid MCOs, BCBS State plans, Aetna, and/or Cigna
Highly organized and relentless about follow-through
Extreme attention to detail and ability to read complex clinical documents, payor feedback, and EHR data related to prior authorization workflows
Clear and confident communication with parents, clinicians, and payor contacts
Problem-solving ability
Comfort with ambiguity and real-time judgment
Must be a US Citizen, Green Card Holder, or eligible for a TN Visa; the application asks about current or future visa sponsorship requirements
Required phone number and resume for application

Benefits

Comp & perks

Opportunity to materially impact the health outcomes of the most vulnerable populations
Opportunity for rapid career growth as Alpaca Health builds out a new function
Join a fast-growing healthcare startup
Join a team taking a technology-first approach to building a scalable digital health platform