Healthcare Project Manager (Healthcare)

TL;DR

Healthcare Project Manager (Healthcare): Leading strategic and operational payment integrity initiatives with an accent on DRG validation, claims adjudication, and technology integration. Focus on ensuring regulatory compliance with HIPAA/HITRUST standards and coordinating cross-functional teams between technical resources and business operations.

Location: Hybrid (Monday-Thursday in-office, Friday remote). Must be based in the US

Salary: $110,000 - $125,000 Annually

Company

hirify.global is a healthcare organization specializing in payment integrity initiatives and regulatory compliance services.

What you will do

• Plan, execute, and monitor healthcare projects, specifically focusing on DRG validation, cost outliers, and readmission reviews.
• Coordinate cross-functional teams including IT and Business operations, as well as external vendors.
• Define project scope, requirements, milestones, and resource needs through stakeholder collaboration.
• Develop project schedules, track progress, monitor budgets, and manage timelines.
• Identify risks, develop mitigation strategies, and escalate issues to senior leadership.
• Ensure all project outcomes and documentation comply with HIPAA, HITRUST, and HITECH regulations.

Requirements

• 4+ years of experience in healthcare project management.
• 2+ years of experience with DRG validation, hospital bill audits, or claims adjudication reviews.
• Deep understanding of ICD-10 coding and healthcare audit practices.
• Knowledge of HITRUST, HIPAA, HITECH, and general healthcare/IT compliance standards.
• Proficiency with MS Project, MS Excel (pivot tables, v-lookups), and MS Office suite.
• Bachelor’s degree in health information management, healthcare administration, or a related field.

Nice to have

• Familiarity with Power BI.
• Experience with payment integrity, claims adjudication, or healthcare fraud/waste/abuse prevention.

Culture & Benefits

• Comprehensive medical, dental, and vision insurance for employees and dependents.
• 401(k) plan with employer matching.
• Generous PTO accrued from day one, plus sick leave and 11 observed holidays.
• Wellness perks including Commuter Benefits and FSAs.
• Professional growth opportunities via LinkedIn Learning and on-the-job mentorship.