[Hiring] Prior Authorization Workflow Analyst @Humatahealth

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description The Prior Authorization Workflow Analyst plays a critical role in Humata Health’s customer’s implementation process and post go-live stabilization/maintenance efforts. This role sits at the intersection of hospital operations, Epic workflows, and payer portal automation.

• Partner with hospital PA staff to review prior authorization workflows, referral volumes, and payer mappings.
• Validate existing automations and document requirements for new ones.
• Ensure workflows are fully mapped, tested, and optimized for Humata’s touchless prior authorization solution.

Responsibilities

• Own the operational workstream deliverables for customer implementations including discovery, data collection, and analysis of Prior Authorization workflows.
• Proactively manage all operational workstream tasks of the implementation project plan.
• Be a collaborative and communicative member of the implementation project team, ensuring implementation project manager has visibility into operational progress and risks.
• Conduct operational workflow and portal shadowing sessions with customers, asking thoughtful and specific questions to understand their current processes.
• Identify risks related to the successful implementation of Humata’s PA technology.
• Capture and document operational workflows in Humata’s design workbook to inform solution build and develop prior authorization workflows.
• Review customer payer/plan mix and formulate automation workflow recommendations.
• Adapt future-state workflows and payer/portal additions for customers during stabilization and maintenance phases post go-live.
• Create payer portal credentials to support Humata’s automations.
• Own payer portal validation during testing and go-live project phases; collaborate with the customer’s operations/technical teams to review automation results.
• Document and escalate validation issues to be reviewed/resolved by Humata’s Engineering team.

Requirements

• Bachelor’s degree in Business, Healthcare Administration, or a related field.
• 3+ years hands-on Prior Authorization experience.
• Familiarity with healthcare operations, prior authorization, or revenue cycle workflow optimization.
• Systems knowledge/expertise with Epic (referrals, work queues, coverage), payer portals, and revenue cycle operations.
• Hands-on data analysis experience, ability to analyze referral volumes service line/payer.
• Strong analytical mindset and ability to synthesize large data volumes and make informed decisions based on data analysis.
• Organized, able to document processes (both current state and future-state automations) succinctly.
• Comfort with ambiguity, shifting priorities, and building new processes in an evolving start-up environment.
• Collaborative team player with a consultative approach to client engagement and solution development.
• Utilize PowerBI for reporting, Google Workspace, Slack.
• Willingness to travel as required (up to 25%) for customer onsite discovery sessions and all-company meetings.

Preferred Experience & Skills

• Prior Authorization Expertise: Understand the end-to-end Prior Authorization process (including pre and post-auth touchpoints). Hands-on experience working with payer portals.
• Strong Epic user knowledge (Cadence, Referrals, Coverage/Work Queues), comfortable pulling/analyzing data (Excel/SQL helpful).
• Operational & process mindset: Can map workflows end-to-end and identify bottlenecks.
• Experience with healthcare software and familiarity with HIPAA compliance and PHI handling.
• Innovative problem-solver who brings curiosity, creativity, and structure to ambiguous challenges.
• Adept at navigating complex challenges and can think critically to solution and remove barriers.

Benefits

• Contribute to innovative solutions that improve healthcare efficiency and patient outcomes.
• Enjoy working remotely while being part of a collaborative team, with access to our new office in Winter Park, FL.
• Enjoy competitive base compensation, equity through our Employee Stock Option Plan, and bonus-eligible roles.
• Full benefits package including unlimited PTO and 401k program with employer match.
• Advance your career in a fast-paced, high-impact environment with ample professional development.
• Join a diverse workplace where your ideas and contributions are valued.

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