Manager, Prior Authorization

About the role

Meet knownwell, weight-inclusive healthcare for all. Join a dynamic company that is changing the way obesity care is delivered. We offer weight management, primary care, nutrition counseling, and health coaching. Our care model combines in-clinic and virtual care to bring support to patients where and when they need it. Backed by $50M in funding—including a $25M round led by CVS Health Ventures with support from a16z Bio + Health, Flare Capital, MassMutual, and Intermountain Ventures—we’re scaling fast and expanding access to evidence-based obesity care nationwide.

Responsibilities

• Manage and coach a team of Prior Authorization specialists, including performance management, scheduling/coverage planning, and staffing continuity across in-house and BPO/EOR resources.
• Own the outsourced staffing vendor relationship, including capacity planning and quality oversight.
• Own Prior Authorization turnaround time, coverage rate, and backlog metrics; build and maintain visibility into team performance for leadership.
• Drive structured status tracking and work-list management in Athena and CoverMyMeds, ensuring every request has a clear, current status and owner.
• Own and evolve Prior Authorization competency frameworks, training materials, and SOPs so the team handles complex payer requirements (including GLP-1 and other obesity management medication authorizations) consistently and correctly.
• Partner directly with clinicians on cases with unusual complexity or turnaround/communication issues, exercising independent judgment on escalations and physician relations.
• Identify and fix breakdowns in process or tooling (e.g., macros, escalation paths, notification workflows) that create patient-facing failures.
• Lead hiring, onboarding, and ramp-up of new Prior Authorization team members.
• Report on Prior Authorization performance and risk to Central Operations leadership, flagging staffing or payer-side issues early and proactively.

Requirements

• 5-7 years of prior authorization experience, including 3+ years in a leadership role managing a Prior Authorization or similar insurance-facing operations team.
• Deep working knowledge of the Prior Authorization lifecycle, payer requirements, and tools like CoverMyMeds and an EHR (Athena strongly preferred).
• Experience managing distributed or blended teams (in-house + BPO/outsourced), including vendor management.
• A track record of building process and measuring it — you default to structured tracking and metrics, not tribal knowledge.
• Strong cross-functional communication skills; comfortable being the connective tissue between clinicians, operations, and patients.
• Calm under staffing or volume pressure, with a bias toward fixing root causes rather than patching symptoms.
• Familiarity with GLP-1s or obesity management medications, and a genuine investment in weight-inclusive, patient-centered care, is a strong plus.

Benefits

• Fully remote opportunity
• Medical, dental, and vision insurance
• 401K retirement plan with company match
• Up to 20 days of PTO per year + company holidays
• Up to 14 weeks of parental leave (12 for non-birthing parents)
• Annual work from home stipend for remote employees