PAHub & Prior Authorization Specialist

Position Summary

The PAHub & Prior Authorization Specialist serves as a trusted consultant to customers and internal teams, helping maximize the value, effectiveness, and adoption of PAHub. This role bridges the gap between product functionality, customer operations, implementation, account management, training, and support.

Key Responsibilities

• Serve as a PAHub subject matter expert for customers throughout implementation, optimization, training, and ongoing support activities.
• Participate in customer calls, workshops, business reviews, and operational meetings.
• Develop trusted relationships with customer stakeholders by understanding their workflows, goals, challenges, and business requirements.
• Advise customers on industry best practices and optimal use of PAHub functionality.
• Identify opportunities to improve customer efficiency, automation, turnaround times, and overall satisfaction.
• Conduct PAHub demonstrations for prospective and existing customers.
• Showcase new features, product enhancements, and best practices.
• Deliver customer training sessions tailored to different user roles and operational functions.
• Absorb and share customer feedback, trends, and opportunities with Product Management and leadership teams.
• Assess customer utilization of PAHub and identify opportunities for improvement.
• Recommend workflow changes, configuration updates, and training opportunities to increase efficiency.
• Help customers leverage existing functionality before pursuing custom development.
• Support feature adoption initiatives and change management efforts.
• Track customer challenges and coordinate with internal teams to ensure timely resolution.
• Partner with the Documentation and Training teams to create, review, and improve customer-facing materials.
• Validate user guides, training materials, release communications, knowledge articles, and implementation documentation for accuracy and usability.
• Assist in developing best practice guides, workflow examples, and process documentation.
• Review customer communications to ensure clear and consistent messaging.
• Gather customer feedback and communicate key themes to Product, Engineering, and Leadership teams.
• Advocate for customer needs while balancing product strategy and operational considerations.
• Identify recurring customer questions and contribute to continuous improvements in training and documentation.

Required Qualifications

• 5+ years of experience in healthcare operations, prior authorization, utilization management, PBM, health plan operations, specialty pharmacy, or healthcare technology.
• Hands-on experience with PAHub or a similar prior authorization platform.
• Strong understanding of prior authorization workflows, operations, and regulatory requirements.
• Experience working directly with customers in a consultative or client-facing capacity.
• Excellent presentation, facilitation, and communication skills.
• Ability to explain complex technical concepts to both technical and non-technical audiences.
• Strong analytical and problem-solving abilities.
• Ability to manage multiple priorities in a fast-paced, demanding environment with minimal supervision.
• Maintain the strictest confidentiality in compliance with HIPAA guidelines.
• Highly self-motivated, professional, take-charge attitude with humility and integrity.

Preferred Qualifications

• Experience supporting SaaS healthcare applications.
• Experience in training, customer success, account management, implementation, and/or consulting.
• Knowledge of CMS, Medicaid, Medicare, and commercial utilization management processes.
• Pharmacy Technician certification, pharmacist, or related healthcare credentials.
• Experience creating documentation, training content, or knowledge management materials.

Success Measures

• Customers are effectively utilizing PAHub functionality and adopting new features.
• Customer satisfaction and engagement levels improve.
• Internal teams have access to timely, accurate product expertise.
• Product demonstrations and training sessions are highly effective and well-received.
• Documentation and customer-facing materials are accurate, useful, and easy to understand.
• Customer feedback is translated into actionable improvements that enhance the overall customer experience.

Pay Range

Actual compensation will be determined based on the candidate's experience, qualifications, and work location. Candidates in different geographic markets may be offered compensation that reflects local market conditions.

About the Company

Agadia Health Systems, Inc. is a leading healthcare management technology company addressing the evolving needs of the managed care market with a suite of utilization management solutions in electronic prior authorization, MTM, Part D star ratings & adherence, grievances, and formulary benefit design. Used by the nation’s largest health plans and PBMs, Agadia’s advanced technology solutions help drive operational efficiency, appropriate utilization, compliance, and profitability.

Equal Opportunity Employer

Agadia Health Systems, Inc. is an Equal Opportunity Employer.