Utilization Management Coordinator

Location: Remote USA; five 8-hour days per week, with shifts scheduled between 8:00 AM and 8:00 PM ET. Available schedules include Monday–Friday, Tuesday–Saturday, and Sunday–Thursday.

Salary: $21.70–$27.00 per hour.

Company

hirify.global provides an integrated healthcare platform combining clinical, service, data, and AI capabilities to improve care for older Americans.

What you will do

• Monitor intake queues, validate daily census data, manage correspondence, and accurately enter or route referrals and cases.
• Set up prior authorizations, create cases, resolve authorization inquiries, and verify documentation for clinical review.
• Communicate with members, providers, hospitals, and post-acute facilities to obtain clinical information and coordinate utilization management decisions.
• Schedule peer-to-peer reviews, assign and track Medical Director cases, retrieve medical records, and maintain case documentation.
• Support post-discharge workflows, discharge planning coordination, care transitions, and case follow-up.
• Download and review operational reports using tools such as Looker and Snowflake, while providing administrative support to the team and manager.

Requirements

• High school diploma or equivalent.
• Experience in healthcare operations, utilization management, care coordination, or prior authorization.
• Proficiency with healthcare systems, EHRs, and reporting tools.
• Effective communication with healthcare providers and members.
• Strong organization, multitasking, attention to detail, follow-through, and time management in a high-volume environment.
• Ability to work remotely from the USA and within assigned ET shift coverage.

Nice to have

• Experience with Medicare Advantage or managed care.
• Intake, authorization, clinical coordination, or case management workflow experience.
• 1–3 years of administrative or medical office experience.
• Proficiency with Google Sheets and Google Workspace.
• Bilingual communication skills.

Culture & Benefits

• Low- or no-premium employer-sponsored health, dental, and vision plans.
• Generous paid time off and a parental leave program.
• $100 monthly mobile or internet stipend.
• Stock options for all employees and bonus eligibility for eligible roles.
• 401(k) program and a collaborative, supportive work environment.