Vice President Of Prior Authorization Operations

ABOUT US

IVX Health is committed is to providing world-class service and clinical excellence for all those we serve, ensuring our patients can continue to live their best lives. Growing our national footprint from nine to over ninety infusion centers in the past four years, IVX Health continues to achieve record growth as we pursue becoming the nation's preferred destination for pharmaceutical care of complex chronic conditions. We operate over 95 ambulatory infusion centers across the U.S. (up from 9 six years ago) and are executing an aggressive de novo and M&A expansion strategy to build the leading IV therapy brand in the nation. IVX Health is backed by leading healthcare investors Great Hill Partners and Linden Capital Partners.

IVX Health is a national provider of infusion and injection therapy for those with Rheumatoid Arthritis, Crohn's Disease, Multiple Sclerosis and other complex chronic conditions. IVX offers a different, better approach to caring for our patients and believes it is vital to take the same approach with our employees. We strive to empower our team to succeed while embodying our core values: Be Kind, Do What's Right, Never Settle, Make It Happen, and Enjoy the Ride.

ABOUT THE ROLE

The Vice President of Prior Authorization Operations oversees the process of obtaining financial and medical clearance for patients requiring treatment for chronic conditions. This role entails managing the entire intake process, including pre-registration, Prior Authorization, providing support to providers through liaison functions, and closely collaborating with the billing team.

The success of the Prior Authorization team is gauged by several key metrics:

• Ensuring the appropriate pre-visit steps are taken to facilitate full collection of payments for services rendered.
• Maximizing the timely conversion of referrals received by IVX into authorizations.
• Maintaining high levels of provider and patient satisfaction through efficient workflows and effective communication.
• Collaborating with other stakeholders, particularly operations and sales teams, to ensure a cohesive and organized approach to serving IVX’s patients and providers.

RESPONSIBILITIES

• Manage a team to guarantee a world-class pre-patient and existing patient onboarding experience, predominantly comprised of on-shore personnel, while also overseeing off-shore resources
• Collaborate closely with direct reports to enhance the centralized patient onboarding experience effectively
• Develop, foster, and sustain productive and positive working relationships with key local, regional, and national teams to proactively prevent and resolve issues through effective communication
• Continuously update and maintain patient onboarding policies and procedures in collaboration with the team to facilitate the sustained growth of the company
• Work closely with Product, Operations, and Clinical leadership teams to develop a strategic plan for onboarding new markets, drug therapies, and payor collaborations
• Support the Senior Vice President of Revenue Cycle in monitoring and assessing the staffing and training requirements for both new and existing employees, while also aiding in the development of departmental training programs
• Provide mentorship to team managers to cultivate their leadership skills and confidence, fostering their development as strong and effective leaders
• Develop and assist in reviewing processes and training program construction to ensure they are comprehensive and compliant with company standards and guidelines
• Monitor the performance of centralized intake operations, including reporting, tracking, and resolving potential or escalated issues as they arise
• Deliver comprehensive reporting to offer transparency to the organization regarding the outcomes of the Prior Authorization and intake teams, encompassing metrics such as received and processed volume, productivity, and conversion rates
• Conduct market, health plan, and legislative research as required, and analyze relevant data to inform decision-making processes

BENEFITS

At IVX Health, we value our team members and strive to provide comprehensive benefits that support their overall wellbeing. At IVX Health, we're committed to supporting our employees in every aspect of their lives. Join us and take advantage of these benefits as part of our dedicated team! Here are some of the benefits we offer:

• Comprehensive Medical, Dental, and Vision Insurance: Our plans include prescription drug coverage and telemedicine services, ensuring you have access to the care you need.
• Flexible Savings Options: Choose from Health Savings Account (HSA) and Health Reimbursement Arrangement (HRA) options to manage healthcare expenses efficiently.
• Supplemental Health Protection Plans: We offer additional options for Accident, Critical Illness, and Hospital Indemnity coverage to provide extra peace of mind.
• Dependent Care Flexible Spending Account: Take advantage of pre-tax dollars to cover eligible dependent care expenses.
• Voluntary Short-Term and Long-Term Disability Coverage: Safeguard your income with voluntary disability coverage options.
• Fertility Healthcare and Family Building Benefits: Through our partnership with Carrot, we offer resources and support for fertility healthcare and family building.
• Life and AD&D Insurance: Protect yourself and your loved ones with life insurance and accidental death and dismemberment coverage.
• Free Counseling Services and Resources: Access counseling services and resources for emotional, physical, and financial wellbeing at no cost to you.
• Education Assistance: We support your professional development through tuition reimbursement and certification support.
• CEU Library: Access our Continuing Education Unit library to stay up-to-date in your field and advance your career.
• Charitable Giving Match and Volunteer PTO Program: Give back to your community with our charitable giving match program and volunteer PTO.
• Employee Referral Bonus Program: Refer talented individuals to join our team and earn a bonus for your contribution.
• 401(k) Plan with Company Match: Save for your future with our 401(k) plan, with a company match to help you reach your retirement goals.

Note: Please be aware that the benefits described above may vary for Full Time, Part Time, and PRN employees. Please consult your HR representative for details on eligibility and coverage.

REQUIRED COMPETENCIES AND SKILLS

• Ability to lead and motivate a team of professionals, including managers and staff, to achieve performance goals and maintain high morale
• Excellent verbal and written communication skills to effectively communicate with internal teams, external stakeholders, and senior leadership
• In-depth knowledge of Prior Authorization processes, including regulatory requirements, insurance policies, and healthcare industry standards
• Capability to develop and execute strategic plans for Prior Authorization Operations, including identifying areas for improvement, optimizing workflows, and enhancing efficiency
• Strong analytical abilities to interpret data, identify trends, and make data-driven decisions to improve performance, optimize resources, and address challenges effectively
• Proficiency in leading organizational change initiatives, including process improvements, technology implementations, and workflow optimizations, while managing resistance and ensuring successful adoption

REQUIRED EDUCATION AND EXPERIENCES

• Bachelor’s Degree in Healthcare Management or related field
• Extensive experience with patient intake, Prior Authorization, and clinical documentation
• At least eight (8) years of experience working in a health care organization with a specific background in clinical operations and patient pre-treatment processes
• Strong written and oral communication skills

EEO STATEMENT

IVX Health is proud to be an Equal Opportunity Employer. We value diversity and are committed to creating an inclusive environment for all employees. IVX Health wants to have the best available people in every job, and we make employment decisions on the basis of business needs, job requirements, individual qualifications, and merit. Equal employment opportunities are provided to all employees and applicants for employment without regard to race, color, religion, sex, sexual orientation, gender identity, pregnancy, national origin, military and veteran status, age, physical or mental disability, genetic characteristic, reproductive health decisions, family or parental status, or any other legally protected category in accordance with applicable federal, state, or local laws. IVX Health prohibits discrimination, harassment, or retaliation of any kind based on any of these characteristics. Equal employment opportunity will be extended to all persons in all aspects of the employer-employee relationship and all terms and conditions of employment, including, but not limited to, hiring, training, promotion, discipline, compensation benefits, and separation of employment.