Manager, Risk Adjustment (Healthcare)

Location: Remote, with an ideal candidate based in Pennsylvania

Salary: $87,700–$157,800 per year

Company

hirify.global provides healthcare services and supports access to care for individuals, families, and communities.

What you will do

• Manage risk adjustment and quality improvement business processes for assigned products and health plans.
• Develop cross-functional action plans, detailed workplans, issue logs, and progress reports.
• Partner with departments to implement product business requirements.
• Design and execute operational workflows based on product requirements, competitive conditions, and local market dynamics.
• Evaluate risk adjustment strategy across functional areas and support health plan initiatives.
• Prepare dashboards for senior management and identify improvement opportunities.

Requirements

• Bachelor’s degree in a related field or equivalent experience.
• 4+ years of experience in project management, operations, quality improvement, or data analysis/reporting within healthcare.
• Experience managing cross-functional healthcare processes and business requirements.
• Experience with risk adjustment, operational workflows, or health plan initiatives.

Nice to have

• Clinical or social work experience.
• Managed care or Medicare experience.
• MLTSS experience.

Culture & Benefits

• Full-time employment with a flexible approach to remote, hybrid, field, or office work schedules.
• Health insurance, 401(k), and stock purchase plans.
• Tuition reimbursement, paid time off, and holidays.
• Compensation may vary based on skills, experience, education, and other job-related factors.