Payor Authorization Operations Manager

5+ years Colorado Medicaid authorization experience (LTHH, LTSS or waiver programs). Bachelor's degree in Healthcare Administration, Business, or equivalent is preferred. Colorado Medicaid certification and LTHH authorization training strongly preferred. Existing deep knowledge of Colorado's LTHH ecosystem, HCPF policies, prior auth operations, and ColoradoPAR system. Expert relationship builder with strong communication, problem-solving, and stakeholder management skills. High-agency operator who executes cross-functional work in ambiguous regulatory environments.

Master Colorado's LTHH landscape and lead authorization operations for waiver programs. Oversee end-to-end prior authorization process and manage team. Manage reauthorization submissions to ensure no lapse in care. Act as an expert to help families navigate appeals and coordinate with internal teams. Serve as escalation point for disputed Colorado Medicaid authorizations. Build expertise in Medicaid coordination for Colorado beneficiaries. Create and execute training programs on Colorado-specific authorization requirements.