[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. Apply tot his job