Compliance UMAC 3 (Fri - Mon)

Location: Remote nationwide within the United States. Three 12-hour shifts per week, scheduled Friday–Sunday or Saturday–Monday, between 8:00 a.m. and 9:00 p.m. Eastern Time. Occasional travel to hirify.global offices for training or meetings may be required.

Salary: $44,900–$60,200 per year

Company

hirify.global is a U.S. healthcare and insurance company providing healthcare and wellness services to Medicare, Medicaid, families, individuals, military personnel, and communities.

What you will do

• Review utilization management activities and documentation for compliance with policies, procedures, and regulations.
• Collect and analyze daily, weekly, and monthly data to assess team and individual operational metrics.
• Process QIO fast-track appeals and expedited authorization requests within regulatory turnaround times.
• Interpret guidelines and independently determine appropriate courses of action in complex or ambiguous situations.
• Work with related workstreams while following established procedures and organizational objectives.

Requirements

• 1–3 years of technical experience and a clerical support background in a healthcare environment.
• Proficiency in Microsoft Word and Excel.
• Strong attention to detail, accuracy, and written and verbal communication skills.
• Ability to work independently under general instructions and collaborate in an agile environment.
• Must be able to work remotely within the United States and follow the required Eastern Time schedule.
• Must have a dedicated interruption-free workspace and a wired DSL or cable internet connection with at least 25 Mbps download and 10 Mbps upload speed to protect PHI/HIPAA information.

Nice to have

• Utilization management experience with auditing, compliance, expedited requests, or QIO appeals.
• Associate’s or bachelor’s degree in healthcare, business, finance, or a related field.
• Familiarity with medical terminology and ICD-10 codes.

Culture & Benefits

• Three-day workweek with 12-hour shifts and 40 scheduled weekly hours.
• Medical, dental, and vision benefits.
• 401(k) retirement savings plan.
• Paid time off, company and personal holidays, and paid parental and caregiver leave.
• Short- and long-term disability coverage, life insurance, and other wellness benefits.