Prior Authorization Operations Manager – Buy & Bill

Remote | Full-Time | Monday–Friday | 9:00 AM–6:00 PM EST

About Squad Health

Squad Health provides navigation services and software to US medical practices to remove barriers to treatment, especially access to specialty medications. Our services include benefits investigation, prior authorization, patient assistance enrollment, pharmacy coordination, and patient engagement. Our team members operate as extensions of provider offices.

About the Role

We're hiring an operations manager to help lead our buy-and-bill team, which supports infusion and injectable programs at GI, allergy, and rheumatology practices. You'll oversee daily benefits investigations and prior authorization workflows, including auditing cases for quality and completeness. You'll also manage the hiring pipeline and oversee training sessions to support a rapidly growing team.

The ideal candidate has hands-on buy-and-bill PA experience at a specialty clinic or infusion center, has 2 years managing a team, is fluent with technology, and eager to jump in quickly.

Responsibilities

- Manage and mentor PA/BI Specialists while personally resolving complex clinic escalations.
- Recruit, interview, and onboard offshore PA/BI candidates.
- Train new specialists on end-to-end buy-and-bill workflows and decide when they're ready to work cases independently.
- Track daily team performance (accuracy, turnaround time, follow-ups), give feedback, and retrain where needed.
- Audit BI and PA accuracy: benefit type, cost-share, site-of-care rules, J-codes, NDCs, units, dosing, and auth date ranges.
- Surface operational issues to our ops, product, and tech teams, and use AI tools to improve workflows.

Qualifications

- 4 years of hands-on medical-benefit PA and BI experience for infused or injected specialty drugs at a specialty clinic, infusion center, or medication-access organization.
- 2 years managing a team: tracking performance, giving feedback, and maintaining training materials.




- Working knowledge of HCPCS codes, NDC-to-unit conversion, CPT administration codes, ICD-10 codes
- Deep expertise in health plan perks, including eligibility, INN/OON status, deductible, OOP max, copay/coinsurance, and payer-preferred products
- Experience across commercial, Medicare Advantage, Medicaid, and TRICARE plans in multiple states
- Demonstrated growth opportunities, such as a promotion or expanded responsibilities, in the past 2 years.
- Excellent written and verbal English, strong organization, and hands-on use of AI tools.

Preferred: GI, allergy, or rheumatology biologics (e.g., infliximab, vedolizumab, ustekinumab); site-of-care program experience; managing offshore teams.

Application Questions

- Have you worked directly with U.S.-based clinics or infusion centers? Which specialties and medications did you support?
- How have you recruited and trained new Prior Authorization Specialists? How did you determine when someone was ready to handle cases independently? How did you audit work for accuracy and completeness?
- Give us one example where you used AI, automation, or technology to solve a work problem or make a process more efficient.
- This is a full-time role working Monday–Friday, 9:00 AM–6:00 PM Eastern Time. Are you fully available during these hours?
- What is your notice period?

Work Location: Remote

Pay: ₹90,000.00 - ₹115,000.00 per month

Application Question(s)

- Have you worked directly with U.S.-based clinics or infusion centers? Which specialties and medications did you support?
- How have you recruited and trained new Prior Authorization Specialists? How did you determine when someone was ready to handle cases independently? How did you audit work for accuracy and completeness?
- Give us one example where you used AI, automation, or technology to solve a work problem or make a process more efficient.
- This is a full-time role working Monday–Friday, 9:00 AM–6:00 PM Eastern Time. Are you fully available during these hours?
- What is your notice period?

Work Location: Remote

📌 Infusion Prior Authorization Operations Manager (India)
🏢 Squad Health
📍 India