Director, Payor Operations (Medtech)

TL;DR

Director, Payor Operations (Medtech): Managing payer requirements and operationalizing workflows for a community-oriented primary care platform with an accent on Medicaid managed care and plan-level performance. Focus on translating complex regulatory requirements into scalable operational workflows and driving KPIs across diverse healthcare plans.

Location: Remote (Must be based in the US and authorized to work in the US)

Compensation: $160,000–$165,000

Company

hirify.global is a tech-enabled primary care organization delivering culturally competent care to underserved populations through a durable care platform.

What you will do

• Own and maintain a centralized payer rulebook and translate requirements into clear operational workflows.
• Manage performance outcomes at the health plan level, monitoring KPIs, compliance, and documentation.
• Diagnose root causes of operational issues and lead corrective actions for underperforming plans.
• Lead a team of Plan Owners and a Payor Ops Trainer to ensure consistent execution and clarity.
• Develop training-ready materials and support the rollout of workflow changes in partnership with workforce teams.

Requirements

• 7–10+ years of experience in healthcare operations, payer operations, or compliance.
• Must be authorized to work in the United States.
• Strong working knowledge of Medicaid managed care and payer-driven program requirements.
• Proven experience interpreting regulatory requirements and translating them into operational workflows.
• Experience managing multiple external stakeholders and leading audit or QA processes.
• Strong analytical skills to diagnose operational issues across execution, workflow, and capacity.

Nice to have

• Experience working with CalAIM programs (ECM, Community Supports).
• Experience working across multiple health plans simultaneously.
• Experience in high-growth or scaling organizations.

Culture & Benefits

• Equity compensation package.
• Comprehensive medical, dental, and vision insurance.
• 401k and flexible PTO policy.
• $1,000 home office stipend and provided equipment.
• Opportunity for rapid career progression and personal growth.