Associate Genetic Counselor Reviewer (Genetic Counseling)

Location: Virtual full-time from within reasonable commuting distance of the posting locations in the United States; required in-person training sessions. Schedule: 9:30–6:00 Central Time.

Company

hirify.global is a Fortune 25 healthcare company focused on integrated, personalized, and affordable care through clinical expertise, research, operations, and technology.

What you will do

• Conduct initial medical necessity screenings for routine and simple genetic testing pre-authorization cases.
• Determine whether submitted clinical information meets medical necessity criteria or requires additional review.
• Collaborate with medical directors, senior reviewers, and leaders on complex utilization management, out-of-network, and treatment appropriateness cases.
• Coordinate with providers and communicate pre-authorization decisions to ordering physicians and service provider offices.
• Document clinical review results and determinations in the pre-certification system.
• Review grievance and appeal requests, maintain patient and provider confidentiality, and meet departmental service metrics.

Requirements

• Master of Arts or Master of Science degree from an ACGC-accredited genetic counseling program.
• ABGC board certification required.
• Ability to work the required Central Time schedule and attend in-person training.
• Must live within reasonable commuting distance of a listed posting location unless an accommodation is granted as required by law.

Nice to have

• Familiarity with reimbursement coding for genomic testing, including CPT and ICD-10-CM.
• Experience working in a cross-functional team environment.

Culture & Benefits

• Virtual full-time work model with flexibility and autonomy, subject to training and location requirements.
• Paid holidays, paid time off, and incentive bonus programs.
• Medical, dental, vision, disability, life insurance, and wellness benefits.
• 401(k) with company match, stock purchase plan, and financial education resources.
• COVID-19 and influenza vaccination may be required for certain patient- or member-facing roles.