Utilization Management Rep III (Healthcare)

Location: Virtually full-time from within commuting distance of the Grand Prairie, Texas or Tampa, Florida offices, with required in-person training and occasional office work. Friday through Monday, 10-hour shifts covering 6:30am to 11pm Eastern Time.

Company

hirify.global is a Fortune 25 healthcare company focused on improving lives and simplifying healthcare.

What you will do

• Coordinate cases for precertification and prior authorization reviews for inpatient and outpatient services.
• Provide technical guidance to Utilization Management Representatives handling eligibility questions and member correspondence.
• Handle escalated and unresolved calls and direct representatives to appropriate resources.
• Explain workflows, processes, departmental priorities, and guidelines.
• Support management improvement initiatives and assist with new-hire training.
• Manage calls, texts, faxes, and electronic queues while documenting interactions in a fast-paced environment.

Requirements

• High school diploma or GED.
• At least 3 years of customer service experience in a healthcare-related setting, or equivalent education and experience.
• Medical terminology training required.
• Strong verbal, written, interpersonal, analytical, and problem-solving skills.
• Ability to work the stated Friday-through-Monday schedule and attend required in-person training or office work when necessary.

Nice to have

• Experience in a call center or call-queue environment.
• Facilitation skills and experience supporting Utilization Management operations.

Culture & Benefits

• Structured schedule with occasional overtime or flexibility based on business needs.
• Paid holidays, paid time off, and incentive bonus programs.
• Medical, dental, vision, disability, and life insurance benefits.
• 401(k) with company match, stock purchase plan, wellness programs, and financial education resources.
• Virtual work flexibility with required onboarding and occasional in-office collaboration.

Hiring process

• Applications are reviewed through the hirify.global careers process.
• Specific onsite expectations are discussed during the hiring process.