Utilization and Pre Authorization Analyst (Healthcare)

Location: Hybrid in Minneapolis, Minnesota; onsite presence required three days per week and remote work available two days per week

Salary: $72,500–$85,000 per year

Company

hirify.global provides healthcare operations and medical management services.

What you will do

• Translate clinical, regulatory, vendor, and operational requirements into authorization rules and service data.
• Define documentation standards, testing scenarios, and governance processes.
• Support utilization review, pre-authorization, implementation readiness, and sustainable long-term operations.
• Collaborate with Medical Management, Clinical Operations, IT, vendors, and delegated utilization management partners.
• Organize complex information, identify gaps, and maintain version control across operational documentation.

Requirements

• Bachelor’s degree in health sciences or a related field with 3+ years of progressive healthcare experience, or an associate’s degree with 4+ years of related experience.
• Experience in prior authorization, utilization management, clinical operations, health plan operations, or delegated utilization management operations.
• Knowledge of authorization workflows, service categories, documentation requirements, and routing logic.
• Experience maintaining inventories, rule libraries, logs, trackers, or governance documents with version control and effective dates.
• Strong analytical, organizational, communication, and attention-to-detail skills.
• Ability to work effectively with IT, vendors, Medical Management, Clinical Operations, and other operational stakeholders.

Culture & Benefits

• Hybrid work schedule with three onsite days and two remote days per week.
• Health benefits and a retirement plan with 401(k).
• Paid time off and paid leave, including parental leave.
• Equal opportunity employment practices.