Supervisor, Utilization Management (RN)

Location: Remote in California; California RN license required

Salary: $75,300–$135,400 per year

Company

hirify.global is a diversified national healthcare organization serving 28 million members through its Medical Management and Health Services operations.

What you will do

• Supervise the utilization management clinical review team across prior authorization, concurrent review, and retrospective review.
• Monitor resources and nurse performance against compliance, quality, efficiency, and service standards.
• Collaborate with clinical reviewers, providers, members, and senior management to resolve complex care issues.
• Develop and implement utilization management policies, procedures, guidelines, and quality improvements.
• Educate the team on key initiatives, regulations, accreditation standards, and industry best practices.
• Coach team members and support onboarding, hiring, training, performance feedback, and career development.

Requirements

• Active California RN license required.
• Graduate of an accredited school of nursing or a bachelor's degree.
• 4+ years of related experience.
• Knowledge of utilization management principles is preferred.
• Ability to work remotely from California and supervise utilization management activities.

Culture & Benefits

• Full-time employment with competitive pay.
• Health insurance, 401(k), and stock purchase plans.
• Tuition reimbursement, paid time off, and paid holidays.
• Flexible workplace options, including remote, hybrid, field, or office schedules where applicable.
• Focus on diversity, compliance, quality, and continuous improvement.