Solaris Health

Operations

• Support strategy and improvement of APP utilization and productivity across Urology practices
• Partner with national APP leadership, practice leadership, physicians, APP leaders, and operational stakeholders to implement APP operational strategy
• Analyze enterprise and practice-level data covering APP productivity, financial performance, staffing, utilization, ramping, retention, and operational metrics
• Develop and monitor standardized APP performance benchmarks and scorecards
• Conduct practice assessments and on-site evaluations of workflows, staffing, scheduling, physician-APP care models, and operational barriers
• Develop practice-specific implementation plans to optimize utilization, workflow, access, productivity, and practice performance
• Support implementation, evaluate progress, and address practice-specific operational needs
• Identify and scale high-performing APP models and best practices
• Partner with Finance, Human Resources, Revenue Cycle, Analytics, and practice leadership on compensation, incentive, productivity, and performance models
• Evaluate APP workforce and staffing needs, recruitment, ramping, retention, and capacity expansion opportunities
• Support APP workforce planning and recruitment efforts
• Develop and support APP leadership infrastructure, committees, and practice-level representation
• Establish communication and accountability structures with APP and practice leadership
• Facilitate communication and best-practice sharing across practices
• Partner with Human Resources, Compliance, Credentialing, and practice leadership regarding state regulations, bylaws, credentialing requirements, and policies affecting APP scope and utilization
• Partner with APP clinical leadership to support clinical initiatives, top-of-scope practice, and physician-APP team-based care
• Participate in enterprise and practice leadership meetings and communicate progress, opportunities, and outcomes
• Maintain awareness of national APP operational trends and best practices
• Perform other position-related duties as assigned

Director, APP Operations, UA

Insurance

• Initiate and track insurance prior authorizations for scheduled procedures, imaging, and other medical services
• Verify insurance eligibility and benefits using payer portals or direct contact with payers
• Document authorization statuses accurately in the EMR and Practice Management system
• Obtain authorizations before scheduled dates of service to avoid delays or denials
• Escalate urgent or complex authorization cases to the Manager/Supervisor and Team Lead of Financial Clearance
• Support team objectives and participate in departmental huddles and workflow optimization initiatives
• Participate in ongoing training and feedback sessions
• Communicate with insurance carriers to gather clinical documentation and follow up on pending requests
• Identify and report recurring payer issues or trends to the Supervisor
• Inform patients about authorization status, potential delays, and coverage issues
• Coordinate with patient estimation staff so authorizations align with cost estimates and pre-service collections
• Perform other related duties as assigned
• Adhere to ethical standards, applicable laws, HIPAA requirements, the Solaris Health Code of Conduct, and organizational policies
• Report suspected compliance concerns or violations
• Complete Annual Compliance Training

Insurance Authorization Specialist

Manager

• Lead the development, implementation, standardization, and ongoing optimization of enterprise-wide clinical pathway and navigation programs across multiple affiliates and disease states
• Develop and deliver education and training programs for clinical navigation staff on PCA, BCA, BPH, OAB, and other approved clinical pathways
• Provide leadership and oversight to nurse navigators and other clinical team members
• Ensure compliance with established pathway standards, protocols, and best practices
• Collaborate with physicians, nursing leaders, pharmacy teams, and operational stakeholders to integrate clinical pathways into daily practice
• Serve as the subject matter expert for clinical pathways and navigation programs
• Provide guidance and consultation to affiliated practices and multidisciplinary teams
• Monitor, collect, and analyze pathway adherence metrics, key performance indicators, and patient outcomes
• Identify barriers to pathway adoption and develop corrective action plans and process improvements
• Maintain and update clinical pathway content, educational materials, and implementation tools
• Prepare and present reports, dashboards, and program updates to executive leadership and key stakeholders
• Partner with clinical and operational leadership to drive quality improvement initiatives
• Foster collaboration among multidisciplinary teams and affiliates
• Engage with external partners, industry organizations, and professional societies to remain current on emerging trends and best practices
• Advocate for resources, technology, and support to sustain and expand navigation and clinical pathway programs
• Maintain patient confidentiality and report suspected compliance concerns or violations
• Complete annual compliance training
• Perform other position-related duties as assigned

Clinical Pathway Navigation Manager

• Initiate and track insurance prior authorizations for scheduled procedures, imaging, and other medical services
• Verify insurance eligibility and benefits using payer portals or direct contact with payers
• Document authorization statuses accurately in the electronic medical record and Practice Management system
• Ensure authorizations are obtained before scheduled dates of service to avoid delays or denials
• Escalate urgent or complex authorization cases to the Manager/Supervisor and Team Lead of Financial Clearance
• Support team objectives and contribute to departmental huddles and workflow optimization initiatives
• Participate in ongoing training and feedback sessions
• Communicate with insurance carriers to gather clinical documentation and follow up on pending requests
• Identify and report recurring payer issues or trends to the Supervisor
• Inform patients of authorization status, potential delays, and coverage issues
• Coordinate with patient estimation staff to align authorizations with cost estimates and pre-service collections
• Adhere to ethical standards, applicable laws, regulations, the Solaris Health Code of Conduct, and organizational policies
• Maintain confidentiality of protected health information in compliance with HIPAA
• Report suspected concerns or violations and complete Annual Compliance Training
• Perform other position-related duties as assigned

Certified Coder

• Review chart documentation for accuracy and completeness
• Identify inconsistencies in chart documentation and work with staff and the Coding Supervisor to resolve issues
• Communicate with Claims Resolution Specialists and Business Office staff to resolve errors and clarify issues
• Code diagnoses, procedures, and modifiers accurately according to established coding guidelines
• Work collaboratively with providers to obtain complete documentation supporting coding
• Meet quality and productivity standards and monitor compliance with policies and procedures
• Identify process opportunity trends and recommend efficiency improvements
• Maintain current knowledge of coding guidelines and relevant state and federal regulations
• Ensure adherence to third-party and governmental regulations relating to coding, documentation, compliance, and reimbursement
• Participate in special projects, personal development training, and cross-training
• Inform the Coding Supervisor of trends, inconsistencies, discrepancies, or payer changes
• Collaborate with peers and functional areas of the Coding and Revenue Integrity department
• Maintain patient confidentiality and complete Annual Compliance Training
• Perform other position-related duties as assigned

Director, APP Operations, UA

Insurance Authorization Specialist

Clinical Pathway Navigation Manager

Insurance Authorization Specialist

Coder, Certified Radiation Oncology