Supervisor, Utilization Management (Healthcare)

Location: Remote in Nevada; Monday–Friday, 8:00 AM–5:00 PM PST. Candidates must hold a valid, active, unrestricted Nevada RN license or a Compact RN license and be willing to obtain a Nevada RN license.

Salary: $75,300–$135,400 per year

Company

hirify.global provides healthcare services focused on improving access to care for individuals, families, and communities.

What you will do

• Supervise prior authorization, concurrent review, and retrospective clinical review teams.
• Monitor utilization management resources, performance, compliance, quality, and efficiency.
• Collaborate with clinical teams and senior management to resolve complex member-care issues.
• Develop and implement utilization management policies, procedures, and guidelines.
• Coach, evaluate, onboard, hire, and train utilization management team members.
• Identify and lead process, quality, and organizational improvements.

Requirements

• Graduate of an accredited nursing school or a bachelor's degree.
• 4+ years of related experience.
• Active, unrestricted Nevada RN license or Compact RN license with willingness to obtain Nevada licensure.
• Knowledge of utilization management principles is preferred.
• Ability to work 8:00 AM–5:00 PM Pacific Time, Monday–Friday.

Culture & Benefits

• Remote work arrangement with a flexible approach to remote, hybrid, field, or office schedules.
• Health insurance, 401(k), stock purchase plans, tuition reimbursement, paid time off, and holidays.
• Work focused on improving healthcare access and outcomes.
• Equal opportunity workplace committed to diversity and inclusion.