Habitat Health empowers older adults to experience more good days in their homes and communities. Through the Program of All-Inclusive Care for the Elderly (PACE), we provide comprehensive medical care along with support for daily needs such as meals, transportation, and in‑home assistance. We deliver coordinated clinical and social care in our centers and directly in participants’ homes, creating a fully integrated experience that brings peace of mind and a true sense of belonging. As we expand our scalable, affordable PACE model to meet the growing and complex needs of aging populations, our mission‑driven care teams continue to help participants live well on their own terms.

Habitat Health is supported by leading healthcare organizations and investors including New Enterprise Associates, Kaiser Permanente, and Town Hall Ventures. We are entering a period of significant growth and are looking for exceptional teammates to help us scale a better model of care for older adults. To learn more, visit www.habitathealth.com.

Role Scope:

The Sr. Authorizations Associate is a key member of Habitat Health’s centralized, shared authorizations team within Value Based Care Operations. This non-clinical role owns the end-to-end authorization workflow, from validating new referrals through finalization, post-service authorizations, and follow-up, with local clinical teams. Working within strict regulatory timeframes, the Authorizations Coordinator keeps every referral accurate and moving so participants receive services on time, and so Habitat Health always knows what has been authorized, delivered, and billed.

The role’s core accountability will include:

Ensures all referrals and authorizations, across all systems of record, including post-service and retro-authorization requests, are processed within strict regulatory timeframes to support timely delivery of services to participants.
Tracks authorization timelines, expirations, and extensions to help guarantee regulatory and internal turnaround times are met.
Reviews and validates all referrals for completeness (participant, provider, and reason details; required clinical approvals, network status) before handing off to scheduling.
Owns timely, compliant follow-up and close-out of referrals, including confirming follow-up from after visit summaries.
Works closely with the local care delivery teams to route requests that require clinical review to the appropriate PCP or IDT members and tracks them to a decision. Partners with Patient Access, Medical Records, Network Management, Claims, and local care teams to resolve authorization-related discrepancies and keep handoffs on time.
Facilitates single case agreements end-to-end with the Network team when needed.
Keeps referral and authorization status accurate as enrollment changes (new enrollees, disenrollment, completed visits).
Documents all actions, contacts, and outcomes accurately in the EHR and authorization systems, following standardized workflows and HIPAA requirements.

Qualifications:

Associate’s degree (or equivalent combination of education and experience) and 2+ years of experience in prior authorization, referral coordination, or healthcare administration required.
Bachelor’s degree in healthcare administration or a related field preferred;
Working knowledge of medical terminology, health insurance benefits, and authorization processes; Medicare/Medicaid managed care experience strongly preferred
Experience with single case agreements, out-of-network authorizations, or retro-authorizations preferred; familiarity with Kaiser Permanente referral processes is a plus
Experience with electronic health records (e.g., Epic), payer portals, and authorization management systems; proficiency in Microsoft Office
Strong attention to detail, organization, and time management, with the ability to manage multiple deadlines and own turnaround times
Ability to adapt to changes and learn new systems quickly
Excellent verbal and written communication skills
A strong passion for our mission, with a high degree of empathy for the populations we serve.