Manager, Revenue Cycle Management Authorization

The Manager, RCM – Authorization is responsible for leading the Prior Authorization (PA) team and managing all aspects of authorization workflows, documentation, training, and process optimization. This role oversees the development and delivery of internal and external training resources, maintains compliance with evolving regulations, and ensures accurate and effective prior authorization operations. The ideal candidate has a strong background in RCM and clinical operations, excellent communication skills, and the ability to lead a high-performing team in a fast-paced environment.

Duties and Responsibilities

· Oversee daily operations of the prior authorization function, ensuring efficient processes and high accuracy

· Lead, mentor, and manage a team of RCM support staff in the PA area

· Create and maintain comprehensive documentation, job aids, training guides, and process overviews

· Collaborate with internal teams to ensure up-to-date and compliant PA resources

· Present training materials to internal staff and external clients, tailoring content to specific needs

· Proofread and edit notification templates to ensure clarity and regulatory compliance

· Design and develop engaging visuals using tools like Visio, Lucid, Canva, Figma, or Miro

· Build workflows and visual training materials to simplify complex PA processes

· Manage vendor relationships with external utilization management partners

· Regularly evaluate training effectiveness and update content and delivery methods accordingly

· Partner cross-functionally to resolve PA-related challenges and ensure efficient end-to-end processes

· Monitor team performance metrics and ensure adherence to company and regulatory standards

· Ensure protection of patients’ PHI in accordance with HIPAA requirements

· Uphold the Baylor Genetics Code of Conduct and report any instances of noncompliance

Skills and Competencies

· Deep understanding of PA workflows, regulatory requirements, and payer-specific guidelines

· Excellent written and verbal communication skills

· Strong document editing, process documentation, and training development expertise

· Proficient in Microsoft Office Suite and design tools such as Canva, Lucid, Visio, Figma, or Miro

· Exceptional organizational and project management skills

· Ability to lead a team while managing multiple projects in a fast-paced environment

· Strong analytical and problem-solving abilities

Education and Experience

Education:

· Bachelor’s degree preferred; equivalent combination of education and relevant work experience will be considered

Experience:

· Minimum of 5 years of experience in Revenue Cycle Management with a focus on prior authorizations

· Diagnostic laboratory experience strongly preferred

· Proven experience managing or leading teams and creating training materials and process documentation

· Experience in cross-functional collaboration and client-facing roles is a plus

Physical Demands and Work Environment

· Frequently required to sit, speak, and use standard office equipment

· Occasionally required to travel for training, client meetings, or conferences

EEO Statement

Baylor Miraca Genetics is proud to be an equal opportunity employer committed to building an inclusive and diverse workforce. We do not discriminate based on race, religion, color, national origin, sex, sexual orientation, age, gender identity, veteran status, disability, genetic information, pregnancy, childbirth, or any other status protected under applicable federal, state, or local law