About Fallon Health
Founded in 1977, Fallon Health is a leading health care services organization that supports the diverse and changing needs of those we serve. In addition to offering innovative health insurance solutions and a variety of Medicaid and Medicare products, we excel in creating unique health care programs and services that provide coordinated, integrated care for seniors and individuals with complex health needs. Fallon has consistently ranked among the nation’s top health plans, and is accredited by the National Committee for Quality Assurance for its HMO, Medicare Advantage and Medicaid products. For more information, visit fallonhealth.org.
Brief Summary of Purpose:
Manages the daily operations of the Prior Authorization Unit; responsible for developing and implementing processes that enhance the efficiency and effectiveness of the Prior Authorization Program. Becomes involved in key FH committees which have any impact on the authorization process. Becomes the subject matter expert (SME) for the Trucare application and regulatory reports as required. Represents the Senior Director of IUM when necessary.
Bachelor’s degree or higher, preferably in focus on healthcare administration, communications or business.