Utilization and Pre Authorization Analyst

The Opportunity:

HealthEZ is seeking a detail-oriented and process-driven Utilization and Pre-Authorization Analyst with a proven track record of success in healthcare operations. As a key member of the Medical Management team, this role will support critical utilization review and pre-authorization functions while collaborating closely with internal and external stakeholders. Reporting to the Director of Clinical Operations, the Analyst will play an important role in ensuring efficient, accurate, and compliant healthcare service delivery.

This is a hybrid position, requiring onsite presence three days per week and offering the flexibility to work remotely two days per week.

What you will do

- Translate clinical, regulatory, vendor and operational requirements into clear authorization rules, service data.

- Establish documentation standards, testing scenarios and governance processes.

- Able to effectively work across different departments within the organization including Medical Management, Clinical Operations, IT.

- Establish and maintain vendor relationships and delegated UM partners.

- Ability to organize complex information, identify gaps, maintain version control.

- Support both implementation readiness and long-term operations sustainability.