Healthcare Operations Specialist

4 weeks ago


Albuquerque, New Mexico, United States Presbyterian Healthcare Services Full time

Prior authorization requests are processed according to established evidence-based criteria. The role involves screening requests not meeting guidelines, gathering additional information, and forwarding requests to relevant parties, including Health, Assistant, Medical Director, Monitoring, and Healthcare teams.

Key Responsibilities:

  • Screen prior authorization requests for compliance with established criteria
  • Gather additional information as needed to support the review process
  • Forward requests to relevant teams, including Health, Assistant, Medical Director, Monitoring, and Healthcare

Why This Role Matters:

This role plays a critical part in ensuring that prior authorization requests are processed efficiently and effectively, allowing Presbyterian Healthcare Services to provide high-quality care to our patients.



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