# Project Manager, Prior Authorization and Referral Transactions **Company**: CVS Health **Location**: Work from home, PA **Work arrangement**: remote **Experience**: senior **Job type**: full-time **Salary**: $60,300.00 - $132,600.00 **Category**: Healthcare **Industry**: Healthcare **Apply**: https://cvshealth.wd1.myworkdayjobs.com/en-US/CVS_Health_Careers/job/PA---Work-from-home/Manager--Project-Management---Prior-Authorization_R1091514-1?utm_source=yubhub.co&utm_medium=jobs_feed&utm_campaign=apply **Canonical**: https://yubhub.co/job/project-manager-prior-authorization-and-referral-8cf436ec-8ec/ ## Description We're building a world of health around every individual , shaping a more connected, convenient, and compassionate health experience. As a Project Manager, Prior Authorization and Referral Transactions, you will be responsible for the project management, operational coordination, and production support of Prior Authorization and Referral transactions and provider-facing workflows. **Responsibilities** - Manage and coordinate projects and enhancements supporting Prior Authorization and Referral transactions, workflows, and provider experiences. - Serve as a primary point of contact for Production Support ticket issues, coordinating investigation, escalation, tracking, and resolution with appropriate business and technology partners. - Partner with business, technology, EDI, interoperability, and other stakeholders to investigate and resolve transaction and workflow-related issues. - Coordinate project activities including requirements gathering, documentation, milestone tracking, risk and issue management, testing, implementation readiness, and post-production support. - Support analysis of Prior Authorization and Referral transaction behavior and provider workflows to identify root causes, recurring issues, and opportunities for improvement. - Coordinate business testing activities for system enhancements and releases, including test scenario development, defect management, validation, and implementation support. - Translate business and provider needs into clear requirements and work with technology partners to support solution delivery. - Monitor project deliverables, dependencies, risks, and outstanding decisions and proactively escalate items that could affect delivery or the provider experience. - Support intake and prioritization of enhancements, defects, and roadmap opportunities impacting Prior Authorization and Referral capabilities. - Develop and maintain project documentation, workflow documentation, status reporting, issue tracking, and stakeholder communications. - Facilitate cross-functional meetings and working sessions to drive decisions, remove blockers, and ensure clear ownership of deliverables. - Support implementation and post-release monitoring to validate expected outcomes and quickly identify production issues. - Act as a key operational and project resource for continuous improvement of Prior Authorization and Referral transaction capabilities and provider-facing workflows. **Requirements** - 5–7 years of healthcare-related work experience. - Experience supporting Authorization and Referral workflows, preferably within payer, provider, EDI, or healthcare transaction environments. - Demonstrated project management experience coordinating work across business and technology teams. - Experience with production issue management, including investigation, triage, escalation, root-cause identification, and coordination through resolution. - Experience supporting requirements gathering, business testing, implementation, and post-production activities. - Strong analytical, problem-solving, and decision-making skills. - Strong collaboration and teamwork skills with the ability to coordinate across multiple business and technology stakeholders. - Strong written and verbal communication skills, including the ability to translate technical or transaction-related issues into clear business language. - Ability to manage multiple priorities, project deliverables, and production issues in a fast-paced environment. - Demonstrated growth mindset, adaptability, and willingness to develop deeper expertise in Prior Authorization and Referral capabilities. **Education** - Bachelor’s degree in Business Administration, Healthcare Administration, Information Systems, Project Management, or a related field preferred. - Equivalent combination of education and relevant healthcare, Prior Authorization/Referral, EDI, or project management experience may be considered in lieu of a degree. **Benefits** - Medical, dental, and vision coverage - Paid time off - Retirement savings options - Wellness programs - Other resources, based on eligibility For more fresh new jobs, check out [yubhub.co](https://yubhub.co/). ## Skills ### Required - project management - Prior Authorization and Referral transactions - production support - analytical skills - problem-solving skills - communication skills ### Nice to have - Authorization and Referral workflows - payer - provider - EDI - healthcare transaction environments --- Source: [Apply at cvshealth.wd1.myworkdayjobs.com](https://cvshealth.wd1.myworkdayjobs.com/en-US/CVS_Health_Careers/job/PA---Work-from-home/Manager--Project-Management---Prior-Authorization_R1091514-1?utm_source=yubhub.co&utm_medium=jobs_feed&utm_campaign=apply)