Senior Process Improvement Professional (Healthcare)

Location: Remote nationwide within the United States; U.S. citizenship required. 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 people covered by Medicare, Medicaid, and military healthcare programs.

What you will do

• Analyze TRICARE policy, industry guidelines, and claims-processing operations to identify improvement opportunities.
• Develop, implement, and oversee sustainable, repeatable, and measurable business process improvements.
• Collect and analyze complex claims data, run queries, identify root causes, and provide recommendations.
• Evaluate process changes against defined goals and benchmarks using quantitative and qualitative measures.
• Coordinate projects and programs, support technical implementations, and assist with change management.
• Communicate findings and recommendations to senior and executive-level leadership.

Requirements

• At least 5 years of experience in business analysis, testing, or process management.
• Current experience with claims adjudication, related systems, and reporting.
• Strong experience working with complex datasets, including SQL or PL/SQL queries and data interpretation.
• Knowledge of healthcare applications and technology, with experience reading contracts, policies, and operations manuals.
• Ability to manage multiple initiatives independently and communicate technical details to senior and executive audiences.
• U.S. citizenship is required, government security clearance approval through NBIS is required, and candidates living in Puerto Rico cannot be hired.

Nice to have

• Bachelor's degree.
• Knowledge of Medicare or TRICARE.
• Experience leading programs, technical implementations, or process optimization initiatives.
• Experience with workflow design and business process optimization.

Culture & Benefits

• Remote work from a dedicated home workspace with internet service meeting minimum speed requirements of 25 Mbps download and 10 Mbps upload.
• 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 wellness-focused benefits.