Description

Norton Healthcare seeks a System Director, Authorization Management & Pre-Service to lead strategy, operations, and optimization of authorization and pre-service functions across our integrated health system. This executive will oversee workflows that support timely authorizations, financial clearance, and a positive patient access experience. Responsibilities include driving performance improvement, managing KPIs and denials, ensuring regulatory and payer compliance, collaborating with clinical and revenue cycle leaders, and leveraging technology and analytics. The role requires strong leadership, change management, and communication skills in a complex healthcare environment.
Provide strategic leadership for authorization management and pre-service operations across Norton Healthcare.
Design and optimize workflows to ensure timely, accurate authorizations and financial clearance.
Collaborate with clinical, revenue cycle, and access teams to enhance patient experience and throughput.
Monitor KPIs, analyze trends, and implement process improvements to reduce denials and delays.
Ensure compliance with payer, regulatory, and accreditation requirements.
Lead, develop, and mentor managers and staff, fostering a culture of accountability and engagement.
Partner with IT to leverage technology, automation, and analytics for operational efficiency.
Develop and manage budgets, resource plans, and performance goals for assigned functions.
Revenue cycle management
Prior authorization workflows
Pre-service financial clearance
Utilization management
Healthcare operations leadership
Data analytics and KPI development
Compliance and regulatory knowledge (CMS, payer rules)
EHR/EMR and authorization platforms
Process improvement/Lean/Six Sigma
Budgeting and financial management
Medical Insurance
Dental Insurance
Vision Insurance
Life Insurance
401k
RN, RHIA, RHIT, CHAM, CRCR, or related certification preferred
Formal training or certification in process improvement (e.g., Lean, Six Sigma) preferred
Proven track record leading authorization, pre-service, or revenue cycle operations in a health system