Authorizations Manager, Outpatient Oncology

Founded in 2007, The Oncology Institute of Hope and Innovation (TOI) is advancing oncology by delivering highly specialized, value-based cancer care in the community setting. TOI is dedicated to offering cutting edge, evidence-based cancer care to a population of more than 1.7 million patients including clinical trials, stem cell transplants, transfusions, and other care delivery models traditionally associated with the most advanced care delivery organizations. With 100+ employed clinicians and more than 700 teammates in 75+ clinic locations and growing. TOI is changing oncology for the better.

JOB PURPOSE AND SUMMARY:

The Manager of Authorizations is responsible for overseeing the strategic and operational functions of the pathology and tertiary care authorization processes. This position ensures compliance with all applicable regulations, drives process improvement, and leads a team to deliver timely, accurate authorizations that support patient care. The Manager collaborates with cross-functional leaders, develops policies, monitors key performance indicators, and serves as a subject matter expert in pathology and tertiary and office visit authorizations.

ESSENTIAL DUTIES AND RESPONSBILITIES:

• Manage the daily operations of the pathology and tertiary and office visit authorizations department, including resource allocation and departmental performance.
• Hire, train, mentor, and evaluate staff; build a high-performing team aligned with organizational goals.
• Analyze workflows, implement standardized procedures, and identify areas for process improvement.
• Monitor departmental KPIs such as turnaround times, denial rates, staff productivity, report trends and drive improvements.
• Serve as an escalation point for complex or high-risk authorization cases and payer disputes.
• Ensure compliance with federal, state, and organizational policies related to healthcare authorization and data privacy (e.g., HIPAA).
• Develop and maintain strong relationships with physicians, specialty departments, insurance carriers, and administrative stakeholders.
• Lead internal audits and oversee corrective actions to ensure continuous quality improvement.
• Coordinate with IT and EHR teams to optimize system configurations for authorization workflows.
• Live and exemplify TOI core values, providing outstanding customer service and promoting a positive experience for patients and staff members.

KNOWLEDGE, SKILLS, AND ABILITIES:

• Proven leadership experience in a healthcare setting with the ability to manage people, performance, and change effectively.
• Strong operational knowledge of pathology and tertiary care and/or office visit workflows, authorization guidelines, and insurance payer requirements.
• Skilled in data analysis, reporting, and use of metrics to improve processes and outcomes.
• Ability to communicate clearly and persuasively across clinical, administrative, and executive levels.
• Proficient in healthcare systems, EHR platforms, and payer portals; ability to evaluate and implement new tools as needed.
• Deep understanding of compliance requirements, including HIPAA, CMS guidelines, and state-specific regulations.
• Capable of managing multiple priorities while maintaining attention to detail in a fast-paced environment.
• Skilled in conflict resolution, coaching, and developing team members to support career growth and retention.
• Strong project management skills and the ability to drive cross-functional initiatives to completion.
• Customer-service orientation with a focus on improving the patient and provider experience.

EXPERIENCE, EDUCATION AND/OR TRAINING:

• High School Diploma or equivalent required; Associate’s or Bachelor's degree in healthcare administration, business, or a related field strongly preferred.
• Minimum of 3 years of experience in healthcare authorization, with at least 2 years in a leadership role (supervisory or above).
• LVN/LPN or any nursing school or experience is preferred.

PHYSICAL WORKING REQUIREMENTS:

The position involves prolonged periods of sitting at a desk, extensive computer use, and phone interaction. Additionally, the role may require occasional lifting of up to 20 pounds for office supplies or equipment.

The physical demands described above are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.