Supervisor, Utilization Management Technician (Medtech)

TL;DR

Supervisor, Utilization Management Technician (Medtech): Overseeing a team of prior authorization technicians and managing administrative workflows for health benefit management with an accent on Medicare compliance and clinical guideline adherence. Focus on optimizing staffing, resolving escalated provider issues, and ensuring high-quality service delivery in a fast-paced startup environment.

Location: Must be based in the US (Remote or Hybrid in NYC area).

Salary: $70,000 - $80,000 USD.

Company

hirify.global is an enterprise health technology company providing comprehensive health benefit management solutions and a proprietary Enterprise Health Platform for employers and health plans.

What you will do

• Oversee a group of prior authorization technicians and manage select administrative PA functions.
• Analyze data to provide recommendations for staffing, workflow, and system enhancements.
• Support ongoing training, coaching, and performance management for direct reports.
• Investigate and resolve escalated issues from clients and providers.
• Review pharmacy claims data for proactive outreach and clinical intervention.
• Ensure adherence to HIPAA guidelines, internal SOPs, and quality standards.

Requirements

• Active, unrestricted National Certified Pharmacy Technician (CPhT) license required.
• Minimum 1 year of Medicare experience, including policies and guidelines.
• Minimum 1 year of Medicare Prior Authorization and/or appeals experience.
• Strong clinical background required.
• Proficiency in Microsoft Office Suite (Excel and PowerPoint).
• Ability to work flexible schedules, including on-call weekend and holiday rotations.

Nice to have

• 2+ years of leadership experience.
• Strong understanding of CMS regulations and payer requirements.
• 2+ years of PBM or Managed Care pharmacy experience.

Culture & Benefits

• Comprehensive medical, dental, and vision insurance coverage.
• 401(k) plan with company match after one year.
• Paid time off, sick time, and paid holidays.
• Short-term and long-term disability coverage.
• Employee assistance and wellness programs.
• Fast-paced, collaborative startup environment.