Quality Compliance Professional

Location: Remote in Michigan; occasional travel to hirify.global offices for training or meetings may be required.

Salary: $71,100–$97,800 per year, plus eligibility for a bonus incentive plan.

Company

hirify.global is a U.S. healthcare and insurance company serving Medicare, Medicaid, families, individuals, military personnel, and communities.

What you will do

• Collaborate with internal and external customers on clinical and non-clinical quality projects.
• Complete medical record reviews and support compliance with regulatory requirements for members and health plans.
• Guide efforts toward successful NCQA accreditation.
• Analyze quality data and implement corrective actions when needed.
• Interpret quality compliance requirements and determine appropriate actions with minimal direction.
• Complete time-sensitive deliverables and take on additional responsibilities based on business needs.

Requirements

• Must reside in Michigan.
• Bachelor’s degree and a clinical background.
• Experience with Long-Term Services and Supports (LTSS) populations and NCQA accreditation.
• Office practice or hospital experience.
• Strong oral, written communication, presentation, and analytical skills.
• Proficiency with Microsoft Word, Excel, and PowerPoint.

Nice to have

• Registered Nurse (RN) license.
• Two or more years of experience with LTSS populations and NCQA accreditation.
• Knowledge of HEDIS, Stars, CMS, or healthcare quality.
• Experience with Dual Eligible Special Needs Plan (D-SNP) programs or CPHQ certification.
• Project management skills and the ability to work independently under general instructions.

Culture & Benefits

• Full-time schedule of 40 hours per week.
• Remote work from a dedicated space that protects member PHI and HIPAA information.
• Home internet requirements include at least 25 Mbps download and 10 Mbps upload speeds.
• Benefits include medical, dental, and vision coverage, 401(k), paid time off, holidays, parental and caregiver leave, disability coverage, and life insurance.