Supervisor, Utilization Management (RN)

Location: Remote in California, United States

Salary: $75,300–$135,400 per year

Company

hirify.global provides healthcare services focused on improving access to care and supporting healthier lives.

What you will do

• Supervise prior authorization, concurrent review, and retrospective clinical review teams.
• Monitor utilization management resources and clinical review activities for performance, compliance, quality, and efficiency.
• Collaborate with clinical teams, members, providers, and senior management to resolve complex care issues.
• Develop and implement utilization management policies, procedures, guidelines, and process improvements.
• Evaluate team performance, provide coaching, and support career development.
• Assist with onboarding, hiring, and training utilization management team members.

Requirements

• Graduate of an accredited nursing school or a bachelor's degree.
• 4+ years of related experience.
• Knowledge of utilization management principles preferred.
• Registered Nurse state licensure and/or compact state licensure required.
• California RN licensure required.

Culture & Benefits

• Full-time employment with a flexible remote, hybrid, field, or office work approach.
• Health insurance, 401(k), and stock purchase plans.
• Tuition reimbursement, paid time off, and holidays.
• Competitive pay and potential additional incentives.
• Equal opportunity workplace committed to diversity.