Senior STARS Improvement, Clinical Professional (Healthcare Quality)

Location: Remote, must reside in Florida. 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 and insurance company serving Medicare, Medicaid, families, individuals, military personnel, and communities.

What you will do

• Identify performance-improvement opportunities for assigned providers.
• Conduct virtual provider visits focused on education, HEDIS outcomes, member care, and two-way feedback.
• Attend joint operating committee meetings and discuss HEDIS, clinical quality, and member outcomes.
• Communicate clinical quality initiatives to providers and staff.
• Educate providers on reducing potentially preventable events and improving Medicaid CAHPS survey results.

Requirements

• Florida RN license and residence in Florida required.
• Bachelor’s degree in nursing.
• Experience with Medicare, Medicaid, or dual-eligible populations.
• Experience in a fast-paced insurance or healthcare setting and collaboration with cross-functional teams.
• Knowledge of STARS, HEDIS, and other healthcare quality measures.
• Analytical, written, verbal communication, and Microsoft Office skills.

Nice to have

• Medical coding certification.
• Knowledge of hirify.global’s internal policies, procedures, and systems.
• Medicaid health plan experience.

Culture & Benefits

• Full-time schedule of 40 hours per week.
• Remote work requires a dedicated workspace that protects member PHI and HIPAA information.
• Minimum home internet speeds of 25 Mbps download and 10 Mbps upload.
• Medical, dental, and vision coverage, 401(k), paid time off, holidays, parental and caregiver leave, disability coverage, and life insurance.