Job Title: Remote Manager – Hospital Inpatient Authorization

Location: Fully Remote (U.S. Based)

Position Type: Full-Time | Exempt

Schedule: Monday – Friday, standard business hours (with flexibility for time zones and urgent cases)

About the Role

We are a mission-driven healthcare services firm delivering exceptional revenue cycle and utilization management support to hospitals across the U.S. We are seeking a skilled and experienced Manager – Hospital Inpatient Authorization to lead and coordinate inpatient authorization operations for multiple hospital clients. This fully remote leadership position requires deep knowledge of hospital admitting workflows, payer communication protocols, insurance verification, and inpatient medical necessity criteria.

Key Responsibilities

Lead a remote team of patient registration and authorization specialists supporting hospital inpatient workflows
Oversee payer admission notifications, insurance verification, and inpatient authorization submission/follow-up processes
Serve as the primary liaison between hospital case management teams, payers, and internal reviewers for escalations and complex cases
Review inpatient clinical documentation to support timely and accurate prior authorization submissions
Ensure compliance with payer-specific notification timeframes and regulatory requirements (Medicare, Medicaid, Commercial)
Monitor team productivity and performance through established KPIs and reporting dashboards
Provide coaching, training, and process improvement guidance to authorization staff
Maintain and update internal documentation on payer workflows, portals, and authorization grids
Collaborate cross-functionally with registration, billing, and UM teams to streamline inpatient processing and minimize denials

Required Qualifications

Minimum 3–5 years of experience in hospital inpatient authorizations, utilization management, or admitting/registration
Prior management or supervisory experience in a healthcare or hospital setting (remote team leadership a plus)
Deep understanding of payer notification workflows, medical necessity criteria, and payer-specific policies
Familiarity with hospital EMR systems (Epic, Cerner, Meditech, etc.) and third-party payer portals (e.g., Availity, UHCprovider, NaviNet)
Strong knowledge of insurance types, including Medicare FFS, Medicare Advantage, Medicaid, and commercial plans
Excellent critical thinking, documentation, and escalation management skills
Must reside in the U.S. and be authorized to work without sponsorship

Preferred Qualifications

Experience with InterQual or MCG criteria
RN, LVN, or Clinical background preferred (not required)
Lean or process improvement experience a plus
Bilingual (English/Spanish) is a plus

Compensation and Benefits

Competitive salary (commensurate with experience)
Health, dental, and vision insurance
401(k) with company match
Paid time off and company-observed holidays
Company-provided equipment and tools
Fully remote work environment with flexible scheduling and strong team culture

Job Type: Full-time

Pay: $25.00 - $40.00 per hour

Work Location: Remote

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Remote Manager – Hospital Inpatient Authorization