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Director Insurance Prior Authorization Jobs in Madison, WI

Kerix

Family Practice - Without OB Physician

Madison, WI · On-site

$300K/yr

... for prior authorizations, this is the antidote. What Makes This Different * Hour-long patient ... No insurance hassles. Direct Primary Care means no billing headaches, no prior-auth battles, and ...

SSI Technologies, LLC

Director of Sales

Janesville, WI · On-site

$125 - $150/hr

Minimum of 5 years of prior people leadership and management experience required. * Proven track ... Applicants must be authorized to work for any employer in the U.S. We are unable to sponsor or take ...

amphenol

Director of Sales

Janesville, WI

Minimum of 5 years of prior people leadership and management experience, required. * Proven track ... Applicants must be authorized to work for ANY employer in the U.S. We are unable to sponsor or take ...

Amphenol

Director of Sales

Janesville, WI · On-site

Minimum of 5 years of prior people leadership and management experience, required. * Proven track ... Applicants must be authorized to work for ANY employer in the U.S. We are unable to sponsor or take ...

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Director Insurance Prior Authorization information

What does a director insurance prior authorization do?

A Director of Insurance Prior Authorization oversees the processes required to obtain insurance approvals for medical procedures, prescriptions, or treatments. They manage teams responsible for submitting prior authorization requests and ensure compliance with insurance guidelines and regulations. Their role includes improving workflow efficiency, reducing denials, and collaborating with healthcare providers and insurance companies. Additionally, they analyze trends to optimize the authorization process and provide training to staff on policy changes.

What are the key skills and qualifications needed to thrive as a director insurance prior authorization?

To thrive as a Director of Insurance Prior Authorization, you need expertise in healthcare administration, insurance processes, and regulatory compliance, typically supported by a bachelor's or master's degree in healthcare or business administration. Familiarity with prior authorization software, electronic health records (EHRs), and payer systems is crucial for overseeing efficient authorization workflows. Strong leadership, problem-solving, and communication skills help drive team performance and manage complex stakeholder relationships. These skills ensure timely approvals, reduce claim denials, and maintain regulatory compliance, which directly impact patient access and organizational revenue.

What are some common challenges faced by a director insurance prior authorization, and how can they be effectively managed?

A Director of Insurance Prior Authorization often encounters challenges such as navigating constantly changing insurance requirements, ensuring timely approvals for patient care, and managing high volumes of authorization requests. Effective management involves staying updated on payer policies, implementing robust tracking systems, and fostering strong communication between clinical, administrative, and payer teams. Building a knowledgeable team and utilizing technology to streamline workflows can also help reduce denials and improve turnaround times.

What is the difference between Director Insurance Prior Authorization vs Insurance Authorization Specialist?

AspectDirector Insurance Prior AuthorizationInsurance Authorization Specialist
CredentialsBachelor's degree, industry certifications often preferredHigh school diploma or equivalent, relevant certifications beneficial
Work EnvironmentManagement level, overseeing teams and processesOperational role, performing authorization tasks
Employer & Industry UsageHospitals, insurance companies, healthcare organizationsMedical offices, insurance companies, healthcare providers
Primary ResponsibilitiesOverseeing authorization processes, policy compliance, team managementProcessing authorization requests, verifying coverage, documentation

The main difference is that the Director Insurance Prior Authorization manages teams and oversees authorization policies, while the Insurance Authorization Specialist handles the day-to-day processing of authorization requests. Both roles require knowledge of insurance policies, but the director position involves leadership and strategic oversight.

What are popular job titles related to Director Insurance Prior Authorization jobs in Madison, WI?

For Director Insurance Prior Authorization jobs in Madison, WI, the most frequently searched job titles are:

What job categories do people searching Director Insurance Prior Authorization jobs in Madison, WI look for?

The top searched job categories for Director Insurance Prior Authorization jobs in Madison, WI are:

Director Insurance Prior Authorization jobs near you
Infographic showing various Director Insurance Prior Authorization job openings in Madison, WI as of August 2026, with employment types broken down into 83% Full Time, 14% Part Time, and 3% Contract. Highlights an 90% In-person, 2% Hybrid, and 8% Remote job distribution.

Family Practice - Without OB Physician

Kerix

Madison, WI • On-site

$300K/yr

Full-time

Medical, Dental, Retirement, PTO

This job post has expired 1 day ago. Applications are no longer accepted.

Job description

Get Your Passion for Medicine Back

Advocate MD is a physician-led Direct Primary Care (DPC) practice growing from eight doctors to ten across our five Madison-area clinics. We're looking for two Family Medicine physicians who want to practice real, relationship-based medicine - without the administrative grind of a large health system or the business burden of running your own solo practice.

If you're tired of 15-minute visits, endless charting, and fighting insurance companies for prior authorizations, this is the antidote.

What Makes This Different
  • Hour-long patient visits. Time to actually listen, diagnose, treat, and build real relationships.
  • Small panels, real care. You'll see roughly 6 7 patients per day - a fraction of the typical primary care volume.
  • Room to do procedures. Enough time in each visit to manage more of your patients' care yourself.
  • No insurance hassles. Direct Primary Care means no billing headaches, no prior-auth battles, and none of the administrative barriers that pull you away from medicine.
  • Physician-owned, physician-run. Enjoy the autonomy and lifestyle of DPC without the burden of owning and operating your own practice.
  • A true team. Join a collegial group of eight (soon to be ten) physicians across a well-established, five-clinic practice.
Schedule & Path to Full Panel
  • Full-time: 3.5 4 days per week
  • Initial Panel: 225-250 patients, with ramp up at your speed
  • Full panel: patients (panel size is your choice), at which point compensation reaches up to $300,000/year, scaled to panel size.
Compensation & Benefits
  • Base salary from $225,000/year at 225 patients, with guaranteed pay during panel-building
  • 401(k) with employer matching
  • Health insurance
  • Dental insurance
  • Paid time off
  • Outstanding work-life balance
About Advocate MD

Advocate MD is a physician-led Direct Primary Care practice with locations in East Madison, Middleton, Fitchburg, Sun Prairie and Janesville, Wisconsin. Our model is built around the idea that medicine works best when physicians have the time and autonomy to truly know their patients - without the red tape of traditional fee-for-service care or the overhead and burden of running an independent practice.

Ready to Practice Medicine the Way You Trained For?

We'd love to meet you and talk about what practicing DPC medicine with Advocate MD looks like. Reach out today to learn more about joining our growing team.

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