[Hiring] Supervisor - Benefits Eligibility and Authorization @Cardinal Health

Role Description

Supervise and coordinate the daily activities of the oncology authorization team to ensure timely completion of authorization requests and financial clearance activities.

• Monitor work queues, assign priorities, and manage staff productivity to support timely patient treatment and service scheduling.
• Oversee prior authorization, referral, and medical necessity processes for medical oncology, radiation oncology, imaging, genetic testing, surgery, specialty medications, and ancillary services.
• Review escalated cases, denied authorizations, urgent treatment requests, and payer issues to ensure timely resolution.
• Ensure authorizations are obtained prior to service, tracked appropriately, and renewed or extended as needed to avoid treatment delays.
• Collaborate with physicians, advanced practice providers, nursing, pharmacy, scheduling, and financial counseling teams to resolve authorization barriers and support patient readiness for treatment.
• Conduct daily huddles, staff coaching, and workflow reviews to drive accountability, quality, and service excellence.
• Monitor authorization turnaround times, aging inventories, pending requests, and high-priority patient cases to ensure departmental performance goals are met.
• Maintain expertise on payer policies, medical necessity requirements, authorization guidelines, and regulatory changes impacting oncology services.
• Review authorization-related denials, identify root causes, and implement corrective actions to reduce revenue leakage and prevent recurring issues.
• Perform quality audits to ensure authorization accuracy, documentation compliance, and adherence to organizational policies and procedures.
• Develop and maintain department standard operating procedures, training materials, and payer-specific workflows.
• Generate and analyze daily, weekly, and monthly operational reports, including authorization approval rates, denial trends, productivity, and turnaround times.
• Partner with Revenue Cycle, Patient Access, Managed Care, and Clinical Leadership teams to improve authorization efficiency and financial performance.
• Support staff development through training, performance management, mentoring, and competency assessments.
• Ensure compliance with Medicare, Medicaid, commercial payer, IPA, and other regulatory requirements governing authorization and financial clearance activities.
• Serve as the primary escalation point for complex authorization issues, payer disputes, peer-to-peer reviews, and treatment-related access concerns.
• Lead continuous improvement initiatives focused on reducing treatment delays, improving patient experience, increasing authorization approval rates, and minimizing preventable denials.

Qualifications

• Bachelor's degree in Healthcare Administration, Business, Nursing, or related field preferred.
• Minimum five (5) years of healthcare prior authorization, financial clearance, patient access, or revenue cycle experience preferred.
• Minimum two (2) years of leadership, supervisory, or team lead experience in a healthcare setting preferred.
• Oncology, infusion, radiation oncology, specialty pharmacy, or multi-specialty authorization experience strongly preferred.
• Extensive knowledge of medical oncology treatment regimens, radiation oncology services, imaging, genetic testing, surgical procedures, and specialty referrals.
• Strong understanding of Medicare, Medicaid, commercial payer, HMO, IPA, and delegated authorization requirements.
• Experience managing prior authorization workflows, referral management, medical necessity review, and payer compliance.
• Proven ability to reduce authorization-related denials, treatment delays, and revenue risk through effective operational oversight.

Requirements

• Experience developing, monitoring, and reporting operational KPIs, productivity metrics, quality audits, and performance dashboards.
• Strong analytical, problem-solving, and process improvement skills with the ability to identify trends and implement corrective actions.
• Excellent leadership, coaching, performance management, and employee development skills.
• Ability to effectively manage workload prioritization in a fast-paced oncology environment with competing patient care and payer deadlines.
• Strong communication and relationship-building skills with physicians, clinical staff, executives, payers, and external partners.
• Proficiency with electronic health records (EHRs), practice management systems, authorization platforms, Microsoft Excel, and reporting tools.
• Demonstrated commitment to compliance, regulatory requirements, patient-centered care, and operational excellence.
• Preferred certifications include CRCR, CHAM, CPAR, CPC, or other revenue cycle, reimbursement, or healthcare access certifications.

Benefits

• Medical, dental and vision coverage
• Paid time off plan
• Health savings account (HSA)
• 401k savings plan
• Access to wages before pay day with myFlexPay
• Flexible spending accounts (FSAs)
• Short- and long-term disability coverage
• Work-Life resources
• Paid parental leave
• Healthy lifestyle programs