Senior Accreditation & Licensing Professional (Healthcare)

Location: Remote in Kentucky, United States; occasional travel to hirify.global offices may be required for training or meetings.

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

Company

hirify.global is a U.S. healthcare and health insurance company serving Medicare, Medicaid, individual, military, and community populations through insurance and healthcare services.

What you will do

• Lead accreditation readiness activities and support external reviews, audits, and regulatory surveys.
• Monitor accreditation standards, state and federal regulations, contractual requirements, and organizational policies.
• Coordinate TPA licensing applications, renewals, regulatory filings, and licensing governance across applicable states.
• Prepare internal audits, coordinate documentation and responses, and track compliance remediation.
• Analyze quality, operational, and risk data to develop reports, metrics, dashboards, and improvement recommendations.
• Partner with Legal, Compliance, Risk Management, operations, and leadership on corrective actions and continuous improvement.

Requirements

• Bachelor’s degree.
• At least five years of experience in accreditation, compliance, licensing, healthcare operations, quality management, risk management, analytics, process improvement, or program implementation.
• At least three years of experience in process improvement, data analytics, compliance, risk management, or program management.
• Strong analytical, problem-solving, technical, organizational, and project management skills.
• Advanced proficiency in Excel, Access, and database management, with the ability to translate data into actionable insights.
• Ability to work remotely from Kentucky with a dedicated workspace protecting member PHI/HIPAA information and internet speeds of at least 25 Mbps download and 10 Mbps upload.

Nice to have

• Advanced degree in healthcare administration, public health, business administration, healthcare analytics, business analytics, or a related field.
• Experience with NCQA, URAC, CMS, TPA, UM, or UR licensing programs.
• Knowledge of healthcare regulatory requirements, delegated services, and payer operations.
• Experience with SQL, data modeling, Tableau, Power BI, Qlik, or similar analytics tools.
• Experience leading audit readiness, compliance remediation, root-cause analysis, or process improvement initiatives.

Culture & Benefits

• Full-time schedule of 40 hours per week with remote work.
• Medical, dental, and vision benefits.
• 401(k) retirement savings plan, paid time off, holidays, and paid parental and caregiver leave.
• Short-term and long-term disability coverage and life insurance.
• Dedicated home workspace and privacy controls are required to protect member information.