• 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.