Director of Risk Adjustment Regulatory Audits

Location: Remote nationwide within the United States; occasional travel to hirify.global offices for training or meetings may be required.

Salary: $150,000–$206,300 per year, plus eligibility for a bonus incentive plan.

Company

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

What you will do

• Develop strategy and oversee execution of external risk adjustment regulatory audits.
• Establish operational processes for audit intake, record submission, tracking, reporting, and regulatory communication.
• Analyze audit data and results to reduce financial risk and inform future strategy.
• Identify and implement technology solutions that improve audit workflow efficiency and accuracy.
• Build cross-functional partnerships with quality, cost, strategy, market risk adjustment, legal, and regulatory compliance teams.
• Set team goals, priorities, staffing plans, and budgets while supporting a positive organizational culture.

Requirements

• 5+ years of project and people leadership experience.
• 8–10+ years of experience in strategic operations and analytics, including process improvement and stakeholder influence.
• 5+ years of program development and management experience using metrics and performance reporting.
• 5+ years of process improvement and operations experience.
• Strong influencing, collaboration, and written and verbal communication skills.
• This role is not eligible for work visa sponsorship.

Nice to have

• Experience communicating with external regulators.
• Experience presenting to senior leadership.

Culture & Benefits

• Remote work with a dedicated workspace required to protect member PHI and HIPAA information.
• Home internet connection of at least 25 Mbps download and 10 Mbps upload is required.
• Medical, dental, and vision benefits.
• 401(k) retirement savings plan, paid time off, holidays, and paid parental and caregiver leave.
• Short- and long-term disability coverage, life insurance, and additional wellness benefits.