Clinical Practice Consultant

Location: Fully remote within the United States; not limited to the posting location. Local travel of 20% or less and occasional overnight travel may be required.

Base pay: $70,600–$149,600 per year, plus eligibility for an annual incentive bonus.

Company

hirify.global provides health insurance and managed care services with a focus on quality, value-based care, and member outcomes.

What you will do

• Support quality imperatives, value-based care models, and provider relationships for assigned medical practices and primary care providers.
• Develop clinical models and programs, conduct clinical readiness assessments, and support joint operating committees.
• Improve targeted HEDIS, STAR, quality, and performance measures through provider engagement and operational improvements.
• Implement provider-based member outreach initiatives, supplemental data submissions, and medical record retrieval throughout the year.
• Evaluate the effectiveness of quality improvement programs and provide consultative support to clinical, care management, and network teams.
• Build working relationships with medical directors, clinic directors, physicians, care coordination teams, and internal clinical operations teams.

Requirements

• Current, unrestricted license as a Registered Nurse, Physician Assistant, or Nurse Practitioner in the state of operations.
• At least four years of experience in health insurance, managed care, or medical group insurance.
• Knowledge of federal and accreditation standards and regulations for the health insurance industry.
• Experience designing clinical programs and conducting member or provider training presentations.
• Ability to collaborate with physicians, work independently, communicate effectively, and influence internal and external stakeholders.
• Must be located in the United States; visa sponsorship is not available.

Nice to have

• Residence in Florida, Georgia, Alabama, Mississippi, South Carolina, North Carolina, Pennsylvania, Delaware, New York, New Jersey, or Connecticut.
• Experience with population health, value-based care, clinical performance analysis, or practice transformation.
• Demonstrated success improving HEDIS, STAR, quality, or performance metrics.

Culture & Benefits

• Professional development plans and opportunities for career growth.
• Medical and wellness benefits, a 401(k) savings plan, pension plan, and paid time off.
• Paid parental leave, disability insurance, supplemental life insurance, and an employee assistance program.
• Paid holidays, tuition reimbursement, and other incentive programs.