Drive excellence in managing complex Prior Authorization claims at Manulife. This hybrid role demands skilled case management and direct communication with members and providers in a customer-focused environment.
As a Drug Prior Authorization Case Manager, you'll autonomously manage intricate claims while ensuring top-tier service. A deep understanding of drug requests, clinical guidelines, and extensive research is essential. Your expertise will directly support various stakeholders, providing critical guidance and mentorship.
Key Responsibilities:
- Oversee the complete lifecycle of complex drug claims
- Communicate results to members, providers, and pharmacies
- Research and resolve non-standard authorization scenarios
- Support internal teams with Prior Authorization guidance
- Manage escalated claims issues proactively
Requirements:
- Post-secondary education or relevant experience
- 2-3 years in case management or claims environment
- Proficiency in Microsoft Office 365 applications
- Knowledge of medical terminology and benefits administration
- Strong analytical and communication skills
Enhance the customer experience and become a subject matter expert at Manulife.
Prior Authorization Case Manager at Manulife in Waterloo employer: manulife
Manulife is an exceptional employer that prioritizes employee growth and well-being, offering a flexible work environment where innovation thrives. As a leader in AI Model Risk Governance, you'll have the opportunity to shape industry standards while collaborating with diverse teams across the globe. With a commitment to inclusion and professional development, Manulife empowers you to build a meaningful career in a supportive atmosphere.
