Supervisor, Utilization Management Support (Healthcare)

TL;DR

Supervisor, Utilization Management Support (Healthcare): Managing day-to-day operations of Utilization Management Coordinators to ensure timely prior authorization processing with an accent on team leadership, regulatory compliance, and operational efficiency. Focus on optimizing AI/LLM-enabled workflows, managing clinical coordination, and ensuring adherence to CMS and Medicare Advantage policies.

Location: Remote (USA)

Salary: $58,000 - $80,000 annually

Company

hirify.global is a healthcare company on a mission to improve the well-being of older Americans through an integrated care platform that merges advanced data and AI.

What you will do

• Lead, coach, and develop the Utilization Management Coordinator team, monitoring productivity and performance.
• Oversee the intake and processing of prior authorization requests to ensure timeliness and accuracy.
• Manage clinical review coordination and peer-to-peer scheduling between providers and Medical Directors.
• Own the lifecycle of AI/LLM-enabled workflows, including implementation, monitoring, and performance refinement.
• Collaborate with clinical leadership, provider relations, and claims teams to ensure seamless UM operations.
• Ensure strict compliance with CMS, Medicare Advantage, and internal UM policies.

Requirements

• 3+ years of utilization management or prior authorization experience.
• 1+ year of prior leadership or supervisory experience.
• Experience in Medicare Advantage or managed care.
• Proficiency with healthcare systems, EHRs, and reporting tools.
• Experience driving technology-enabled workflow improvements, particularly with AI/LLM tools.
• Must be based in the USA

Nice to have

• Bachelor’s degree in healthcare operations, business administration, or a related field.
• Experience with intake, authorization, or clinical coordination processes.
• Familiarity with UM or case management workflows.

Culture & Benefits

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