Authorizations Manager

Zócalo Health

10d • $110,000 - $120,000 • Remote

About The Position

Zócalo Health is a tech-enabled, community-oriented primary care organization serving people who have historically been underserved by the one-size-fits-all healthcare system. We partner with health plans, providers, and community organizations to deliver culturally competent primary care, behavioral health, and social care.
Our model is built for populations with high medical and social complexity, where fragmented care drives poor outcomes and unnecessary cost. We combine local, community-based teams with virtual care and modern technology to deliver coordinated, whole-person care where members live and receive support.
Founded in 2021, Zócalo Health is backed by leading healthcare and mission-aligned investors and is scaling rapidly across states and populations. We are building a durable care platform designed to perform in constrained healthcare environments and to lead the shift toward accountable, value-based care.
The Authorizations Manager will join Zócalo Health at a critical time for both our organization and the future of primary care. The opportunity for impact is large and growing, and Zócalo Health will help lead the transition from fee-for-service to value-based care for the growing Latino community in the United States.
This role is responsible for building and leading Zócalo Health’s prior authorization function, establishing the operational infrastructure and scalable workflows required to support Community Supports (CS), Enhanced Care Management (ECM), Community Health Worker (CHW), Behavioral Health (BH), and Primary Care (PCP) services across health plan partners.
The Authorizations Manager will design and implement scalable authorization and referral workflows, ensure compliance with Medi-Cal and managed care plan requirements, and develop operational systems that support accurate, timely submissions and approvals. This role will partner closely with Clinical Operations, ECM, Community Supports, Product, and Revenue Cycle teams to ensure authorizations align with care delivery, documentation standards, and reimbursement requirements.
This leader will build and supervise a team responsible for authorization intake, submission, tracking, reauthorization management, and reporting. The Authorizations Manager will establish performance standards, develop operational dashboards, and use data to drive continuous process improvement. This role will play a key part in standing up and scaling the organization’s authorization operations as Zócalo Health expands its programs and payer partnerships.
This position reports to the Director of Revenue Cycle Management and manages a team of authorization specialists.

Requirements

• 5–6+ years of experience in healthcare operations, or care management operations
• Demonstrated experience leading or supervising operational teams in healthcare or managed care environments
• Experience building or improving operational workflows in healthcare operations such as prior authorization, referral management, care coordination, or utilization management
• Strong knowledge of Medicaid or Medi-Cal managed care authorization requirements
• Experience using EHR systems and operational dashboards to manage workflows and performance metrics
• Strong analytical and problem-solving skills with the ability to use data to drive operational decisions

Nice To Haves

• Direct experience managing prior authorization workflows or teams
• Experience with referral management, care transitions, or patient navigation
• Experience implementing operational dashboards, reporting frameworks, or process automation

Responsibilities

• Build and lead Zócalo Health’s prior authorization function, establishing operational workflows that support Enhanced Care Management (ECM), Community Supports (CS), Community Health Worker (CHW), Behavioral Health (BH), and Primary Care (PCP) services.
• Design and implement scalable processes for authorization intake, submission, tracking, follow up, and reauthorization management to ensure services are approved and delivered within required payer timelines.
• Hire, develop, and manage a team responsible for authorization operations, including conducting regular 1:1 meetings, coaching for performance and development, and setting clear expectations for quality, timeliness, and accountability.
• Establish operational standards and documentation requirements that ensure compliance with Medi-Cal and managed care plan guidelines, including authorization documentation, submission timelines, and record accuracy.
• Monitor and manage authorization workflows and work queues to ensure requests, reauthorizations, and referrals are processed accurately and efficiently.
• Develop dashboards and reporting tools that track authorization turnaround times, approval rates, reauthorization timelines, and operational performance metrics.
• Analyze trends in authorization outcomes and operational data to identify barriers, improve workflows, and reduce delays that impact patient care or reimbursement.
• Partner closely with Clinical Operations, ECM, Community Supports, Product, and Revenue Cycle teams to ensure authorization processes align with care delivery, documentation requirements, and billing workflows.
• Maintain working knowledge of payer authorization policies and program requirements to ensure workflows remain compliant as health plan guidance evolves.
• Coordinate with health plans and payer representatives to address authorization issues, clarify requirements, and resolve escalations when approvals or timelines are at risk.
• Lead ongoing process improvement initiatives that strengthen operational efficiency, reduce administrative burden, and support high quality service delivery.
• Conduct internal audits and quality checks to ensure authorization accuracy, compliance with program requirements, and adherence to organizational standards.

Benefits

• Equity compensation package
• Comprehensive benefits including medical, dental, and vision
• 401k
• Generous PTO policy (up to 15 days per year for FT employees)
• $1,000 home office stipend
• We provide the equipment needed for this role.
• Opportunity for rapid career progression with plenty of room for personal growth.

What This Job Offers

• Job Type: Full-time
• Career Level: Manager
• Education Level: No Education Listed