Process Improvement Lead (Medicaid)

Location: Columbia, SC, United States

Salary: $94,900–$130,500 per year

Company

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

What you will do

• Analyze and measure the effectiveness of existing business processes and develop sustainable, repeatable improvements.
• Develop and execute operational excellence initiatives using structured process improvement methodologies.
• Research internal and external best practices, establish benchmarks, and streamline departmental processes.
• Design and implement new processes, procedures, job aids, onboarding, and training practices.
• Serve as the department point person for compliance, audits, quality reviews, and NCQA materials.
• Collect and analyze data, identify gaps, minimize risk, and advise leadership on functional strategies.

Requirements

• Bachelor’s degree.
• At least 5 years of process improvement experience.
• At least 2 years of project leadership experience.
• At least 2 years of case management and/or utilization management experience.
• Ability to lead multiple initiatives and drive change in a matrixed organization.

Nice to have

• Active Registered Nurse (RN) or Master of Social Work (MSW) license in the state of employment.
• Medicaid compliance and Medicaid industry experience.
• Certification in Lean, Six Sigma, or a comparable process improvement methodology.
• Familiarity with project management tools and resources.

Culture & Benefits

• Full-time schedule of 40 hours per week.
• Medical, dental, and vision benefits.
• 401(k) retirement savings plan.
• Paid time off, company and personal holidays, and paid parental and caregiver leave.
• Short-term and long-term disability coverage, life insurance, and bonus incentive eligibility.