Manager, Prior Authorization Payer Connectivity

Manager of Payer Connectivity for Prior Authorization

The Manager of Payer Connectivity for Prior Authorization plays a pivotal role in optimizing how healthcare providers and payers exchange information related to prior authorizations. This leader is responsible for enhancing the technical infrastructure and administrative workflows that support insurance approval processes, aiming to reduce delays in patient care and improve overall efficiency. The role serves as a strategic bridge between payer requirements, provider workflows, and technology solutions, ensuring streamlined, compliant, and scalable connectivity.

What You'll Do :

• Develop and execute strategies to enhance the automation and interoperability of prior authorization workflows across providers, vendors, and payers.
• Define and maintain a payer connectivity roadmap aligned with organizational goals and report progress to executive leadership.
• Collaborate with engineering, development, and product teams to integrate payer-specific requirements into EHR systems and the Waystar platform.
• Drive initiatives that enable automated submission, tracking, and response handling for prior authorization requests.
• Identify pain points and inefficiencies in current prior authorization processes.
• Design and implement scalable, automated solutions that streamline workflows and reduce manual effort.
• Act as the liaison between internal teams and external payer / provider stakeholders.
• Translate payer needs and industry insights into actionable product and technical requirements.
• Lead, mentor, and develop a team responsible for managing payer connectivity, requirements gathering, and validation criteria.
• Ensure backlog refinement, sprint planning, and retrospectives are executed effectively.
• Provide clarity of goals and equip team members with tools and knowledge for successful delivery.
• Ensure all payer connectivity solutions meet regulatory and industry standards for privacy, security, and data exchange.
• Monitor policy changes and adjust solutions accordingly to maintain compliance.

What You'll Need :

If you're passionate about transforming healthcare through technology and process innovation, and you thrive in a collaborative, forward-thinking environment, we invite you to apply.

About Waystar :

Through a smart platform and better experience, Waystar helps providers simplify healthcare payments and yield powerful results throughout the complete revenue cycle. Waystar's healthcare payments platform combines innovative, cloud-based technology, robust data, and unparalleled client support to streamline workflows and improve financials so providers can focus on what matters most : their patients and communities. Waystar is trusted by 1M+ providers, 1K+ hospitals and health systems, and is connected to over 5K commercial and Medicaid / Medicare payers. We are deeply committed to living out our organizational values : honesty; kindness; passion; curiosity; fanatical focus; best work, always; making it happen; and joyful, optimistic & fun.

Waystar products have won multiple Best in KLAS or Category Leader awards since 2010 and earned multiple #1 rankings from Black Book surveys since 2012. The Waystar platform supports more than 500,000 providers, 1,000 health systems and hospitals, and 5,000 payers and health plans.

Waystar Perks :

Waystar is proud to be an equal opportunity workplace. We celebrate, value, and support diversity and inclusion. Qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, national origin, disability status, genetics, marital status, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws. This applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.

Job Category : Product Strategy

Req ID : R2850