Senior Manager, Claims Quality & Workforce Readiness

Location: Telecommuter; hiring is available in Alaska, Arizona, Arkansas, California, Colorado, Florida, Georgia, Idaho, Iowa, Kansas, Kentucky, Maine, Michigan, Minnesota, Missouri, Montana, Nevada, New Hampshire, New Mexico, North Carolina, Oklahoma, Oregon, South Carolina, South Dakota, Tennessee, Texas, Utah, Washington, and Wisconsin, with some role- or city-based limitations.

Salary: National range $89,300–$151,800; National Plus range $101,900–$173,200.

Company

hirify.global works to improve healthcare and customers’ lives through health insurance services.

What you will do

• Build and lead a systematic claims quality improvement approach using quality findings, operational data, and customer feedback to identify trends, address root causes, and reduce recurring errors and rework.
• Partner with Claims Operations, Quality Assurance, Claims production, Claims Optimization, IT, and other teams to convert findings into corrective actions and sustained improvement.
• Establish and govern knowledge management, documentation, training, workforce support, and operational performance practices across Claims.
• Prepare employees for new systems, automation, AI-enabled workflows, and process changes.
• Monitor claims performance and inventory health, identify risks and improvement opportunities, and lead related cross-functional initiatives.
• Build, coach, and develop a growing team while defining capabilities and practices in an evolving function.

Requirements

• Bachelor’s degree or four years of relevant work experience.
• Seven years of health plan industry or business/operational experience.
• Four years of experience leading and managing teams of direct reports.

Nice to have

• Health plan or healthcare operations experience, particularly in claims or another high-volume transactional environment.
• Experience leading complex operational functions and delivering measurable improvements in quality, processes, and performance.
• Experience building structure and capabilities in an evolving environment, leading change, solving complex problems, and aligning teams.
• Experience using data, continuous improvement practices, technology, automation, analytics, or AI-enabled solutions to improve operational outcomes.
• Experience building or governing knowledge management, training, workforce readiness, or operational performance programs.

Culture & Benefits

• Full-time telecommuter role with a culture focused on collaboration, continuous development, innovation, and meaningful healthcare impact.
• Medical, vision, dental, life, and disability insurance, plus voluntary benefits including pet insurance.
• 401(k) employer match, pension vested after three years, wellness resources, and generous paid time off.
• Tuition assistance for undergraduate and graduate degrees and employee recognition programs.
• On-campus resources, commuter benefits, parking, cafes, wellness facilities, and activities are available for hybrid employees.