At Caris, we understand that cancer is an ugly word—a word no one wants to hear, but one that connects us all. That’s why we’re not just transforming cancer care—we’re changing lives.

We introduced precision medicine to the world and built an industry around the idea that every patient deserves answers as unique as their DNA. Backed by cutting-edge molecular science and AI, we ask ourselves every day: “What would I do if this patient were my mom?” That question drives everything we do.

But our mission doesn’t stop with cancer. We're pushing the frontiers of medicine and leading a revolution in healthcare—driven by innovation, compassion, and purpose.

Join us in our mission to improve the human condition across multiple diseases. If you're passionate about meaningful work and want to be part of something bigger than yourself, Caris is where your impact begins.

Position Summary

The Prior Authorization Manager is a strategic and detail-oriented role within Caris Life Sciences, responsible for leading and optimizing prior authorization (PA) operations. This position ensures timely access to Caris’ molecular and diagnostic testing services by managing the full PA lifecycle across commercial, Medicare Advantage, and Medicaid payors. The Prior Authorization Manager oversees a team of specialists, streamlines workflows, and collaborates cross-functionally to reduce denials and support both patient access and revenue goals.

Job Responsibilities

• Lead and manage daily operations of the Prior Authorization team, ensuring adherence to payer policies, internal KPIs, and regulatory requirements.

• Oversee the intake, submission, follow-up, and resolution of prior authorization requests, including appeals and peer reviews.

• Collaborate with payors, ordering providers, billing, and clinical teams to ensure accurate and complete clinical documentation.

• Analyze trends in PA denials, delays, and approvals; implement data-driven strategies to improve success rates.

• Develop and maintain standardized workflows, training materials, and SOPs to ensure operational consistency and efficiency.

• Serve as the primary liaison to payors and third-party vendors (e.g., Glidian) integrated with the Xifin RCM platform.

• Monitor team productivity and performance; provide coaching, feedback, and opportunities for professional development.

• Ensure PA processes align with billing timelines and minimize reimbursement delays.

• Stay current on regulatory changes affecting prior authorization in molecular diagnostics and precision oncology; adjust strategies accordingly.

Required Qualifications

• Bachelor’s degree in Healthcare Administration, Business, or a related field, or equivalent experience.

• Minimum of 5 years in revenue cycle operations, with at least 3 years focused on prior authorizations in a diagnostics or laboratory setting.

• Proven experience managing staff in a high-volume PA or billing environment.

• In-depth knowledge of commercial and government payer guidelines for molecular/genetic testing.

• Proficiency with Xifin or similar laboratory billing systems and third-party PA platforms (e.g., Infinx, Glidian, Careviso).

• Familiarity with CPT/HCPCS coding and medical necessity documentation.

• Strong analytical, leadership, and interpersonal communication skills.

• Demonstrated ability to lead, coach, and develop teams, fostering a culture of accountability and continuous improvement.

• Skilled in monitoring performance metrics and aligning team goals with organizational objectives.

• Experience in developing and optimizing workflows, SOPs, and training programs to drive efficiency and consistency.

• Ability to identify and implement process improvements that reduce denials and enhance turnaround times.

• Strong grasp of payer policy interpretation and regulatory compliance, particularly in molecular diagnostics and precision oncology.

• Ability to adapt strategies in response to evolving healthcare regulations.

• Proficient in analyzing denial trends and operational data to inform decision-making and improve PA success rates.

• Comfortable using data to drive performance and support revenue cycle goals.

• Excellent interpersonal and communication skills, with a proven ability to collaborate across departments and with external stakeholders.

• Committed to delivering exceptional service to patients, providers, and payors.

Preferred Qualifications

• Experience in oncology, pathology, or precision medicine environments.

• Familiarity with CPT/HCPCS coding and medical necessity documentation.

• Understanding of CMS and commercial payer medical policies related to lab testing coverage.

• Knowledge of utilization management practices and payer-specific prior authorization portals or electronic submission systems.

Physical Demands

• Will work at a computer when not travelling and meeting clients; must possess ability to sit and/or stand for long periods of time.

Training

• All job specific, safety, and compliance training are assigned based on the job functions associated with this employee.

Other

• This position requires periodic travel and some evenings, weekends and/or holidays.

Conditions of Employment: Individual must successfully complete pre-employment process, which includes criminal background check, drug screening, credit check ( applicable for certain positions) and reference verification.

This job description reflects management’s assignment of essential functions. Nothing in this job description restricts management’s right to assign or reassign duties and responsibilities to this job at any time.

Caris Life Sciences is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender, gender identity, sexual orientation, age, status as a protected veteran, among other things, or status as a qualified individual with disability.