Prior Authorization Lead

Job description

**About Us** At 3Y Health, we are building AI-driven software to empower healthcare providers and solve the overwhelming administrative complexity that consumes 40% of the industry’s revenue. Our end-to-end platform unlocks opportunities for clinician entrepreneurs, enabling medical professionals to launch, run, and grow private practices. By supporting these independent practices with the latest AI and automation, we’re helping providers reclaim their time, build thriving businesses, and deliver better outcomes for their communities. 3Y Health is backed by over $200M from top-tier investors including Founders Fund, General Catalyst, Softbank, and 8VC. **About the Role** We are seeking a Prior Authorizations Lead to design, manage, and scale 3Y Health’s prior authorization operations. The ideal candidate will be an operational problem-solver who thrives on efficiency and loves turning complexity into clarity. This role requires a strategic yet hands-on operator who can build scalable systems, streamline workflows, and ensure timely, accurate approvals for our clinician partners across multiple specialties. As the Prior Authorizations Lead, you will own the end-to-end authorization process — from intake and submission to payer follow-up and resolution — ensuring fast turnaround times and exceptional partner experience. You’ll also partner closely with Product, RCM, and Operations teams to leverage automation and process design that reduce administrative burden for providers. ### **Responsibilities** - Lead the end-to-end prior authorization process, including verification, documentation, submission, and follow-up with payers. - Build and optimize workflows that minimize turnaround times and maximize approval rates across multiple specialties. - Partner with Product and Engineering to identify automation opportunities and develop tools that reduce manual work. - Collaborate with RCM and Operations teams to ensure clean handoffs between authorizations, billing, and patient care coordination. - Develop and track KPIs to monitor authorization performance, identify bottlenecks, and continuously improve process efficiency. - Train and manage a growing team or vendor partners to ensure consistent execution and adherence to payer guidelines. - Maintain up-to-date knowledge of payer requirements, clinical criteria, and regulatory changes that impact authorization processes. - Build documentation, playbooks, and SOPs to support scaling into new states, payers, and clinical verticals. **Qualifications** - Bachelor’s degree required - 5–8 years of experience in healthcare operations, prior authorization management, or related RCM functions - Strong understanding of payer requirements, medical necessity documentation, and authorization workflows - Proven ability to lead cross-functional initiatives and manage complex, high-volume processes - Analytical and systems-oriented thinker with a track record of driving measurable improvements in turnaround times and accuracy - Experience with automation tools or EMR/EHR integrations a plus - Ability to work 5 days a week in our San Francisco or New York office with a fully in-person team **Compensation** The estimated salary range for this role is **$100,000–$140,000.** Total compensation for this position may also include stock options. Note that total compensation for this position will be determined by each individual’s relevant qualifications, work experience, skills, and other factors.