Authorizations Supervisor

Authorizations Supervisor- Full Time

Position Summary

The Authorizations Manager leads the prior authorization function across all six sites of service, ensuring every clinic procedure and surgery center case is authorized accurately, completely, and ahead of schedule. This role owns the full authorization lifecycle — from order receipt through payer submission, peer-to-peer coordination, appeal, and approval — and manages a team of authorization coordinators supporting both the clinics and the ASCs. The right candidate combines deep payer knowledge with strong team leadership, treats denials as solvable problems, and understands that in a procedural practice, the authorization pipeline is the revenue pipeline.

About the Practice

California Pain Consultants is a growing, physician-led interventional pain management practice serving San Diego County. Our organization includes four clinic locations — Kearny Mesa, La Mesa, Chula Vista, and Rancho Bernardo — and two ambulatory surgery centers performing a high volume of interventional and implant-based procedures. We are committed to delivering exceptional, evidence-based care to patients living with chronic pain, and to building an operational team that matches the caliber of our clinical work.

Essential Duties and Responsibilities

• Team Leadership: Manage day-to-day operations of the authorizations department, including workload distribution, queue oversight, and daily prioritization across four clinics and two surgery centers.
• Staff Development: Hire, train, coach, and evaluate authorization coordinators; build standard work, productivity benchmarks, and quality audit processes for the team.
• Authorization Operations: Own the end-to-end prior authorization process for interventional pain procedures, including epidural steroid injections, medial branch blocks, radiofrequency ablation, kyphoplasty, spinal cord stimulator trials and implants, sacroiliac joint fusion, and sacral neuromodulation.
• ASC Case Readiness: Ensure surgery center cases are fully authorized, benefit-verified, and documentation-complete well in advance of scheduled dates; partner with ASC schedulers and vendor representatives to keep the advanced procedures pipeline moving.
• Payer Expertise: Manage authorizations across a diverse payer mix, including commercial plans, Medicare and Medicare Advantage, Medi-Cal and managed Medi-Cal, workers' compensation, VA/community care referrals, and personal injury lien cases.
• Denials Management: Track denial and peer-to-peer trends by payer and procedure; lead appeals strategy, escalate systemic issues, and work with clinical leadership to strengthen documentation that supports medical necessity.
• Reporting and Analytics: Develop and report key metrics — turnaround time, authorization aging, denial rate, peer-to-peer conversion, and cases-at-risk — and present them to executive leadership on a regular cadence.
• Systems and Workflow: Maintain accurate authorization records in the practice management system; ensure clean handoffs to scheduling, front office, and billing teams.
• Policy Monitoring: Stay current on payer policy changes, CPT code requirements, and medical necessity criteria affecting interventional pain procedures; communicate changes to providers and staff proactively.
• Cross-Functional Support: Support revenue cycle initiatives, payer contracting analyses, and new service line launches by providing authorization feasibility and payer requirement input.

Qualifications

Required:

• Five or more years of prior authorization, utilization management, or revenue cycle experience in a specialty medical practice or ambulatory surgery center setting.
• Two or more years of supervisory or management experience leading an authorizations, referrals, or revenue cycle team.
• Strong working knowledge of CPT/ICD-10 coding, medical necessity criteria, and payer authorization portals (e.g., Availity, payer-specific UM platforms).
• Experience with commercial, Medicare, Medi-Cal, and workers' compensation authorization requirements in California.
• Proficiency with practice management systems and Microsoft Excel; ability to build and interpret operational reports.

Preferred:

• Experience in interventional pain management, orthopedics, neurosurgery, or another procedure-heavy specialty.
• Familiarity with AdvancedMD or a comparable practice management platform.
• Experience with implant-based procedures and device vendor coordination (e.g., spinal cord stimulation, sacral neuromodulation).
• Certification such as CPC, CRCR, or CHAM, or a bachelor's degree in healthcare administration or a related field.

Key Competencies

• Ownership mentality — treats an unauthorized case as a problem to solve today, not a status to report.
• Clear, proactive communicator with providers, staff, payers, and patients.
• Organized and detail-driven; comfortable managing high volume without letting cases fall through the cracks.
• Calm under deadline pressure, particularly around surgery center case readiness.
• Team builder who develops people and holds a high standard.

Compensation and Benefits

• Salary range: $75,000 – $80,000 annually, depending on experience.
• Medical, dental, and vision insurance.
• 401(k) with employer contribution.
• Paid time off and paid holidays.
• Professional development and certification support.