Prior Authorization, Team Lead

ABOUT US

Circle Medical is the fastest-growing telemedicine provider in the US and has seen incredible growth of over 100% per year over the past three years.

Circle Medical is a venture-backed Y-Combinator healthcare startup on a mission to bring quality, delightful primary care to everyone on the planet. Built by top-tier physicians, engineers, and designers, our medical practice and underlying technology have pioneered how people find and receive care.

More about us can be found on our website.

DESCRIPTION We are seeking a full-time Team Lead for the Prior Authorization team to help support our care coordinators in the processing of insurance prior authorizations for our (US-based) patients. They will also be working closely with (internal and external) healthcare providers, insurance companies, and other facilities to advocate for the healthcare needs of our patients, as well as contribute to the growth of our company and product.

The Lead will be expected to combine knowledge and experience leading teams in critical thinking, contributing to creating and refining patient-centered processes, and adding to strategic solutions that better the team and patient experience to achieve the vision of delivering valuable experiences to our patients.

The Team Lead will be comfortable with escalation cases, uncertainty, be outcome-focused, and obsessed with understanding the team’s and our patient’s needs. The Team Lead will seek input from subject matter experts and empower their team to contribute ideas to workflows and outcomes. Success in this role will be measured by, but not limited to, being highly collaborative, curious, autonomous, and diligent.

WHAT YOU’LL DO

• Act as a subject matter expert in prior authorization (PA) activities, including insurance verification, processing of PA requests, and internal team policies as related to all branches of prior authorization
• Provide guidance and mentorship to the prior authorization team members via coaching, quality assurance reviews, training, and development
• Implement strategies to meet or exceed individual and team KPIs.
• Identify and relay changes in prior authorization and healthcare standards to management with the goal of improving internal policies to ensure compliant and efficient workflows
• Support development of training materials such as guides, scripts and impromptu training for team members to enhance their skills in prior authorization
• Review and highlight team performance regularly, providing feedback and coaching to improve productivity and efficiency, while collaborating with managers to align on performance goals and organizational objectives
• Involvement in onboarding and training of new team members
• Assist with patient escalations and workflow creation and refinement by foster collaboration with other Patient Experience teams (including team leads, manager, and patient care advocates)

WHAT YOU’LL BRING

• College Degree or 1-2 years of experience in a leadership role, demonstrating a track record of successful team management.
• Excellent interpersonal and communication skills.
• Proven ability to adapt to change and guide a team through various challenges.
• Strong problem-solving and decision-making abilities.
• English fluency; Excellent verbal and written skills, including grammar, spelling, and punctuation
• Ability and eagerness to adapt to a fast-paced environment and learn quickly
• Proficient in technology and adept at quickly mastering new systems and programs
• A passion for excellent customer service and problem-solving
• Ability to work independently and with minimal supervision
• Ability to work under pressure and handle multiple tasks simultaneously
• Prior experience in a hospitality, retail, or customer service setting

WHAT WILL GIVE YOU AN EDGE:

• Management or Leadership Studies background is a plus
• Prior experience as a healthcare professional, working in a healthcare facility, or working with insurance
• Working knowledge of medication and treatment prior authorizations, referral and imaging processes, and durable medical equipment
• Proven track record with other startups or VC-funded companies
• Ambition to have a long-term career in healthcare
• Experience living in the US or using the US healthcare system