Post-Acute UM Supervisor (Healthcare)

TL;DR

Post-Acute UM Supervisor (Healthcare): Overseeing utilization management activities across post-acute settings with an accent on clinical oversight, quality reviews, and regulatory compliance. Focus on designing and optimizing AI/LLM-enabled workflows to reduce administrative burden and improve care transition efficiency.

Location: Remote USA

Salary: $95,000–$120,000

Company

hirify.global is an all-in-one healthcare company on a mission to improve the health and well-being of older Americans by combining insurance, clinical care, and technology.

What you will do

• Supervise the Post-Acute UM team, including hiring, training, performance management, and coaching.
• Monitor operational metrics such as timeliness, approval/denial trends, and length of stay to drive performance improvement.
• Ensure consistent application of InterQual criteria and CMS/Medicare Advantage guidelines in review decisions.
• Partner with IT and analytics teams to implement AI/LLM-supported workflows for clinical summarization and decision support.
• Lead quality audits to ensure documentation integrity and compliance with regulatory standards.
• Identify automation opportunities to standardize workflows and improve staff experience.

Requirements

• Active unrestricted RN license with a minimum of 4 years of clinical experience.
• At least 3 years of utilization management experience within a health plan or managed care setting.
• 1–2 years of supervisory or team lead experience.
• Working understanding of AI/LLM tools and their application in clinical or UM workflows.
• Knowledge of InterQual criteria and CMS regulations.
• Must be based in the USA.

Nice to have

• Certification or formal training in InterQual.
• Experience in post-acute care utilization management (SNF, ARU, LTACH).
• Experience leading AI/automation or digital transformation initiatives within care management.

Culture & Benefits

• Employer-sponsored health, dental, and vision plans with low or no premiums.
• Generous paid time off and a comprehensive parental leave program.
• $100 monthly mobile or internet stipend.
• Stock options for all employees and bonus eligibility.
• 401K retirement program.