Client Policy Manager I (Healthcare)

Location: Remote anywhere in the continental US; travel up to 20% may be required.

Salary: $78,000–$106,000 per year.

Company

hirify.global provides healthcare-related client payment policy and claims analysis services.

What you will do

• Manage the integrity, accuracy, completeness, and timeliness of client medical payment policies.
• Analyze periodic updates, industry changes, Health Plan rules, Max Units, and client-specific policy requests.
• Prepare payment policy documents and coordinate reviews with Medical Directors and clients.
• Research medical policy items, analyze client inquiries, and apply decisions to affected policies.
• Perform data and report analytics and communicate findings to internal and external stakeholders.
• Initiate and manage projects while prioritizing multiple deadlines and deliverables.

Requirements

• Active Registered Nurse professional license, preferably BSN, or a bachelor’s degree in a healthcare-related field or equivalent experience.
• Professional coder certification such as CPC, CPC-H, CPC-P, or CCS-P.
• At least 3 years of clinical coding experience, preferably in a payer setting.
• Experience with claims adjudication or utilization review in managed care or healthcare insurance, plus knowledge of CMS, Medicaid, ICD, CPT, HCPCS, and reimbursement methodologies.
• Experience developing medical payment policy edits and working with clients or customers in a healthcare setting.
• Strong analytical, problem-solving, communication, project management, and Microsoft Office skills; ability to handle confidential information and work independently and collaboratively.

Culture & Benefits

• Fully remote work with a dedicated, secure work area and high-speed internet access.
• Flexibility to participate in conference calls across global time zones.
• Medical, dental, vision, disability, and life insurance coverage.
• 401(k) savings plan, paid family leave, and 9 paid holidays.
• 17–27 days of paid time off depending on level and length of service.