---
title: 'Prior Authorization Workflow Consultant at Humata Health, Inc'
canonical: 'https://feeny.ai/job/prior-authorization-workflow-consultant-humata-health-inc-united-states-xxxvv10rkew2'
type: 'job'
last_seen: '2026-09-15'
---

# Prior Authorization Workflow Consultant at Humata Health, Inc

- **Company:** Humata Health, Inc
- **Location:** United States
- **Employment:** full-time
- **Work type:** remote
- **Posted:** 2026-08-21
- **Last confirmed live:** 2026-09-15
- **Apply:** https://jobs.ashbyhq.com/humatahealth/1c4723de-7e61-4bcd-8967-328474a1a1a7

## Job description

🔍 What we're looking for: The Prior Authorization Workflow Consultant plays a critical role in Humata Health’s customer’s implementation process and post go-live stabilization/maintenance efforts. This role sits at the intersection of hospital operations, Epic workflows, and payer portal automation. The PA Workflow Consultant partners with hospital PA staff to review prior authorization workflows, referral volumes, and payer mappings, ensuring seamless alignment with Humata’s automation platform. They will validate existing automations, document requirements for new ones, and ensure workflows are fully mapped, tested, and optimized for Humata’s touchless prior authorization solution.

📍Location: Remote, US or Hybrid - Orlando, Florida, US

✅ Responsibilities

- Own the operational workstream deliverables for customer implementations including discovery, data collection and analysis of Prior Authorization workflows.
- Proactively manage all operational workstream tasks of the implementation project plan
- Be a collaborative and communicative member of the implementation project team, ensuring implementation project manager has visibility into operational progress and risks
- Conduct operational workflow and portal shadowing sessions with customers, asking thoughtful and specific questions to understand their current processes. Identify risks related to the successful implementation of Humata’s PA technology.
- Capture and document operational workflows in Humata’s design workbook to inform solution build and develop prior authorization workflows. Review customer payer/plan mix and formulate automation workflow recommendations
- Adapt future-state workflows and payer/portal additions for customers during stabilization and maintenance phases post go-live
- Create payer portal credentials to support Humata’s automations
- Own payer portal validation during testing and go-live project phases; collaborate with the customer’s operations/technical teams to review automation results
- Document and escalate validation issues to be reviewed/resolved by Humata’s Engineering team

🛠 Role Requirements

- Bachelor’s degree in Business, Healthcare Administration, or a related field.
- 3+ years hands’ on Prior Authorization experience
- Familiarity with healthcare operations, prior authorization, or revenue cycle workflow optimization.
- Systems knowledge/expertise with Epic (referrals, work queues, coverage), payer portals, and revenue cycle operations
- Hands-on data analysis experience, ability to analyze referral volumes service line/payer. This role requires a strong analytical mindset and ability to synthesize large data volumes and make informed decisions based on data analysis
- Organized, able to document processes (both current state and future-state automations) succinctly
- Comfort with ambiguity, shifting priorities and building new processes in an evolving start-up environment
- Collaborative team player with a consultative approach to client engagement and solution development
- Utilize PowerBI for reporting, Google Workspace, Slack
- Willingness to travel as required (up to 25%) for customer onsite discovery sessions and all-company meetings

⭐Preferred Experience & Skills:

- Prior Authorization Expertise: Understand the end-to-end Prior Authorization process (including pre and post-auth touchpoints). Hands-on experience working with payer portals.
- Strong Epic user knowledge (Cadence, Referrals, Coverage/Work Queues), comfortable pulling/analyzing data (Excel/SQL helpful).
- Operational & process mindset: Can map workflows end-to-end and identify bottlenecks.
- Experience with healthcare software and familiarity with HIPAA compliance and PHI handling.
- Innovative problem-solver who brings curiosity, creativity, and structure to ambiguous challenges.
- Adept at navigating complex challenges and can think critically to solution and remove barriers

🚀 Why Join Humata Health?

- Impactful Work: Contribute to innovative solutions that improve healthcare efficiency and patient outcomes
- Remote Flexibility: Enjoy working remotely while being part of a collaborative team, with access to our new office in Winter Park, FL
- Competitive Compensation: Enjoy competitive base compensation, equity through our Employee Stock Option Plan, and bonus-eligible roles
- Comprehensive Benefits: Full benefits package including unlimited PTO and 401k program with employer match
- Growth Opportunities: Advance your career in a fast-paced, high-impact environment with ample professional development
- Inclusive Culture: Join a diverse workplace where your ideas and contributions are valued

- Pay Transparency Humata Health will provide pay transparency information upon application to those in qualifying jurisdictions. Our salary ranges are based on competitive pay for our company’s size and industry. They are one part of the total compensation package that may also include equity, variable compensation, and benefits.  Individual pay decisions are ultimately based on several factors, including qualifications, experience level, skillset, geography, and balancing internal equity. - Humata Health is proud to be an equal-opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, national origin, age, sex, marital status, ancestry, neurotype, physical or mental disability, veteran status, gender identity, sexual orientation or any other category protected by law. - Join us in our mission to transform healthcare while building a life that works in harmony both in and outside the office.

## About Humata Health, Inc

## Company Overview
- **One-liner**: Humata Health provides an AI-powered, end-to-end prior authorization platform that automates the medical review process for healthcare providers and payers.
- **Entity Type**: Private (Series A, Alive)
- **Headquarters**: Winter Park, Florida, United States
- **Founded**: 2023
- **Founders**: Jeremy Friese, MD

## Core Business
- **Primary Industry**: Healthcare IT – prior authorization and utilization management
- **Target Customers**: B2B; healthcare providers (hospitals, health systems) and health insurance payers
- **Mission**: To eliminate the friction of prior authorization through intelligent automation, transparency, and collaboration so every “yes” happens faster, with less effort, and with complete confidence.

## Products & Services
- **Frictionless Prior Authorization™ Platform**: An end-to-end SaaS solution that automates the entire prior authorization lifecycle. Key modules include:
  - **PolicyLink & PolicyMatch**: Digitizes payer policies and matches them to patient cases.
  - **AI-Driven Clinical Review**: Automates medical necessity checks and documentation gathering.
  - **AI-Driven Clinical Bundling**: Groups related procedures for streamlined submissions.
  - **Automated Statusing**: Provides real-time updates on authorization status.
  - **Intelligent Gold‑Carding**: Identifies low-risk cases for expedited approval.
  - **AI-Driven Audit**: Flags post‑approval changes that could trigger denials.
  - **Post‑Auth Monitoring**: Tracks authorizations after approval to prevent lapses.
- **Services & Procedures Product**: Specialized solution for high‑volume, complex procedures, achieving 20‑40% touchless closure on auth requirements.

## Market Standing
- **Valuation / Market Cap**: Not publicly disclosed
- **Key Metric**: Total raised – $25M (Series A, raised in 2024)
- **Notable Investors / Partners**: Blue Venture Fund, LRVHealth, 406 Ventures, Highmark Ventures. In 2026, former CMS Deputy Administrator Elizabeth Fowler joined the board.
- **Growth Signals**: Deployed at hundreds of hospitals nationwide; selected as technology partner for the CMS WISeR pilot program; claims 96% first‑pass approval rates and elimination of 45% of manual touches.

## Competitive Advantages
- **Physician‑led**: Founded by a practicing radiologist (Mayo Clinic, Harvard) who understands clinical workflows firsthand.
- **End‑to‑end coverage**: The only platform addressing both provider and payer sides of prior authorization with a single, unified technology stack.
- **Real‑time payer connectivity**: Direct API, eFax, and portal routing to all major payers.
- **Proven outcomes**: Published provider results show dramatic reductions in manual work and faster approvals.

## Strategic Focus
- Scaling the platform to serve more health systems and payers nationally.
- Deepening integration with EHR systems and expanding AI capabilities for clinical review.
- Advancing partnerships with government programs (e.g., CMS CMMI) to drive value‑based care models.

## Why Work Here
- **Remote‑First**: Fully remote team – no commute required.
- **Mission‑Driven**: “Built for Yes” – every employee directly impacts patient access to care.
- **People‑First Culture**: Emphasizes relationships, ownership, and trust. “We’re not a software business, we’re a people business.”
- **Benefits & Perks**: Comprehensive benefits, 401k with employer match, Employee Stock Option Plan, growth opportunities, inclusive culture.
- **Engineering Culture**: Clinicians, engineers, and healthcare experts collaborate to solve a longstanding industry problem using AI and automation.

## Sources
1. [humatahealth.com](https://www.humatahealth.com/)
2. [humatahealth.com/about-us](https://www.humatahealth.com/about-us)
3. [humata-health-inc.breezy.hr](https://humata-health-inc.breezy.hr/)
4. [cbinsights.com](https://www.cbinsights.com/company/humata-health)
5. [linkedin.com](https://www.linkedin.com/company/humatahealth)
6. [businesswire.com](https://www.businesswire.com/news/home/20260318005520/en/Former-CMS-Leader-Elizabeth-Fowler-Joins-Humata-Health-to-Advance-Innovation-in-AI-Driven-Medical-Review)

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