Clinical Training & Quality Specialist (Healthcare AI)

Location: United States; fully remote with approximately 5% travel. Not eligible for hire in California, New York, or Washington.

Salary: $70,000–$78,000 annually, plus benefits and bonus.

Company

hirify.global provides an AI-powered clinical intelligence platform that improves payer-provider collaboration, prior authorization, payment integrity, cost containment, and healthcare outcomes.

What you will do

• Audit clinical operations decisions against clinical guidelines and apply quality measurements, scoring, and performance improvement analysis.
• Translate QA findings into insights and recommendations for operational leaders and cross-functional partners.
• Develop and deliver structured coaching, onboarding, and ongoing upskilling sessions for Clinical teams.
• Create and maintain SOPs, job aids, workflow guides, and new product readiness materials.
• Lead the QA and training aspects of project implementations, including workflow changes, quality expectations, and training updates.
• Partner with Product, Clinical, Client Services, and Operations to validate workflows, identify quality or compliance risks, support change management, and maintain operational service levels.

Requirements

• Active RN licensure.
• At least 2 years of experience with healthcare coverage determinations.
• Knowledge of NCQA and CMS standards for utilization management authorization decisions and LCD/NCD coverage determinations.
• Ability to conduct effective coaching sessions and understanding of adult learning theory and clinical training.
• Strong verbal and written communication, attention to detail, problem-solving, planning, organization, and stakeholder interaction skills.
• Experience with data collection, management, and analysis; proficiency with Google Workspace, including Sheets, Docs, and Forms.

Nice to have

• Ability to build pivot tables, charts, or dashboards.
• Experience identifying performance trends and root causes through data.
• Experience with quality management systems, structured QA audits, coaching, and constructive feedback.

Culture & Benefits

• Fully remote work with approximately 5% travel.
• Medical, dental, vision, life, and disability insurance, plus an Employee Assistance Program.
• 401(k) retirement plan with company match, flexible spending account, and health savings account.
• Flexible time off and company holidays.
• Up to 14 weeks of paid parental leave and pet insurance.
• Collaborative, inclusive, supportive, and growth-oriented work environment.

Hiring process

• Preliminary phone screening with Talent Acquisition.
• Interviews with the Hiring Manager, Leadership, and cross-functional stakeholders.