Humata Health

Customer Delivery

PriorAuthorizationWorkflowConsultant

Orlando, Florida, United States; United States FULL TIME Remote Friendly
Market Sentiment
HIGH DEMAND

Neural analysis suggests this role is
optimal for Mid candidates.

The Brief

“Prior Authorization Workflow Consultant at Humata Health. Skills: Prior Authorization Workflow, Epic workflows, payer portal automation, workflow automation, data analysis. 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”

What You'll Achieve.

ensuring seamless alignment with Humata’s automation platform; ensure workflows are fully mapped, tested, and optimized for Humata’s touchless prior authorization solution; improve healthcare efficiency and patient outcomes

Industry & Context.

Customer Delivery
Problems you'll solve

analytical mindset; ability to synthesize large data volumes and make informed decisions based on data analysis; Innovative problem-solver; Adept at navigating complex challenges and can think critically to solution and remove barriers

Eligibility Requirements

Willingness to travel as required (up to 25%) for customer onsite discovery sessions and all-company meetings

What They're Looking For.

Must Have

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., 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

Nice to Have

Prior Authorization Expertise: Understand the end-to-end Prior Authorization process (including pre and post-auth touchpoints). Hands-on experience working with payer portals., 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

What You'll Do.

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

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 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

How You'll Work.

Team & Collaboration

Be a collaborative and communicative member of the implementation project team, ensuring implementation project manager has visibility into operational progress and risks; collaborate with the customer’s operations/technical teams to review automation results

Communication Scope

communicative member of the implementation project team; consultative approach to client engagement

Process & Methodology

Own the operational workstream deliverables for customer implementations, Proactively manage all operational workstream tasks of the implementation project plan

Full Job Description

🔍 What we're looking for: The Prior Authorization Workflow Consultant 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. The PA Workflow Consultant partners with hospital PA staff to review prior authorization workflows, referral volumes, and payer mappings, ensuring seamless alignment with Humata’s automation platform. They will validate existing automations, document requirements for new ones, and ensure workflows are fully mapped, tested, and optimized for Humata’s touchless prior authorization solution. 📍Location: Remote, US or Hybrid - Orlando, Florida, US ✅ 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

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