Prior Authorization Supervisor (Oncology)

Location: Brookline, Massachusetts, United States, with remote work and occasional onsite presence

Salary: $96,500–$109,100 per year

Company

hirify.global is a cancer research and patient care institute focused on advancing treatment and reducing the burden of cancer.

What you will do

• Oversee daily prior authorization operations for outpatient and clinic-infused drugs, including on-label and off-label chemotherapy regimens.
• Manage molecular pathology prior authorization workflows and support the design and implementation of new processes.
• Assist with complex medical necessity cases, coverage issues, treatment alternatives, and provider-to-payer medical director discussions.
• Monitor payer policy changes and maintain tools, workflows, and standard operating procedures for the prior authorization team.
• Oversee denial workflows, retro authorizations, peer-to-peer discussions, and payer appeals.
• Monitor productivity, delegate daily work, ensure staffing coverage, and supervise up to 15 direct reports.

Requirements

• Bachelor’s degree in Nursing is required.
• At least 3 years of case management, utilization review, or related healthcare experience.
• Prior patient access experience, revenue cycle experience, and knowledge of payer rules and regulations are required.
• Strong clinical knowledge, analytical and problem-solving skills, organization, communication, and teamwork abilities.
• Massachusetts Registered Nurse licensure is preferred.
• Supervisory experience of 2–3 years is preferred.

Nice to have

• Oncology knowledge.
• Experience supervising clinical and non-clinical staff.

Culture & Benefits

• Remote work is available with occasional onsite attendance.
• Work in an inclusive, diverse, and equitable patient-care and research environment.
• Contribute to cancer research, patient care, education, and public health initiatives.
• Employment is full time.