Senior Process Improvement Professional (Healthcare)

Location: Remote nationwide within the United States; candidates currently living in Puerto Rico cannot be hired. Occasional travel to hirify.global offices for training or meetings may be required.

Salary: $78,400–$107,800 per year, plus eligibility for a bonus incentive plan.

Company

hirify.global is a U.S. healthcare company providing insurance and healthcare services to Medicare, Medicaid, military, family, and individual members.

What you will do

• Analyze provider data and claims-related processes to identify gaps, risks, trends, and improvement opportunities.
• Support claim deferral, workflow management, and operational issue resolution related to provider data.
• Recommend and implement improvements that increase efficiency, accuracy, quality, and consistency.
• Develop metrics, reporting, and root cause analyses to measure performance and guide decisions.
• Partner with operations, process, product, and technology teams on issue resolution, testing, automation opportunities, and process enhancements.
• Support UAT, training, communications, and oversight of system and process changes.

Requirements

• At least 5 years of experience in claims operations, provider data, process improvement, or healthcare operations.
• Experience developing metrics, reporting, performance analyses, and business process improvements.
• Strong written and verbal communication, organizational, prioritization, critical thinking, and independent working skills.
• Proficiency with business systems, reporting tools, Microsoft Office, Excel, PowerPoint, and departmental dashboards.
• U.S. citizenship is required under the Department of Defense contract, along with successful approval for a government security clearance through NBIS.
• Applicants currently living in Puerto Rico are not eligible for hire.

Nice to have

• Bachelor’s degree.
• Experience working with complex data sets, SQL or PL/SQL queries, and data interpretation.
• Experience with VA or TRICARE programs, workflow design, or business process optimization.
• Ability to learn complex processing systems.

Culture & Benefits

• Remote work from a dedicated space that protects member PHI and HIPAA information.
• Home internet requirement of at least 25 Mbps download and 10 Mbps upload.
• 40-hour scheduled workweek.
• Medical, dental, and vision coverage, 401(k), paid time off, holidays, parental and caregiver leave, disability coverage, and life insurance.