Director, Utilization Management (Healthcare)

Location: Remote-FL

Salary: $133,700–$247,400 per year

Company

hirify.global provides healthcare services focused on improving access to effective care for members, families, and communities.

What you will do

• Direct daily utilization management operations, including timeliness, quality, performance outcomes, provider interactions, and regulatory measures.
• Lead utilization management policies and procedures in alignment with corporate, state, and NCQA standards.
• Analyze utilization trends, patterns, and impacts to support effective programs and cost-efficient healthcare outcomes.
• Develop utilization management strategies, recommend improvements, and present results to senior leadership.
• Lead onboarding, hiring, training, performance improvement, and career development for the utilization management team.
• Manage cross-functional initiatives, departmental budget components, and change within the area of responsibility.

Requirements

• Bachelor’s degree and 7+ years of related experience, including prior management experience, or equivalent applicable experience.
• 4+ years of management experience preferred.
• Expert knowledge of healthcare industry regulations, policies, and standards preferred.
• RN registered nurse state licensure or compact state licensure preferred.
• Role is designated Remote-FL.

Culture & Benefits

• Health insurance and comprehensive benefits coverage.
• 401(k) and stock purchase plans.
• Tuition reimbursement.
• Paid time off and holidays.
• Flexible work approaches, including remote, hybrid, field, or office schedules.