Risk Adjustment Program Manager (Healthcare)

TL;DR

Risk Adjustment Program Manager (Healthcare): Managing the day-to-day operations of the External Audit Program with an accent on operational excellence, cross-functional data audit responses, and process refinement. Focus on implementing AI-native monitoring for KPIs and utilizing LLMs to drive efficiency and quality in risk adjustment.

Location: Remote (Must be located within the 50 U.S. states). Preference for residence in the Greater Boston Area. Standard working hours are in Eastern Timezone.

Salary: $73,000 - $125,000 / year

Company

hirify.global is a healthcare company on a mission to improve the well-being of older Americans through an integrated care platform merging advanced data and AI with clinical and service experiences.

What you will do

• Manage day-to-day operations of the External Audit Program to ensure alignment with goals and regulatory timelines.
• Act as a versatile operational resource across retrieval, evaluation, and submission workstreams.
• Partner with workstream leads to identify and implement process improvements for better scalability and quality.
• Communicate updates, risks, and recommendations clearly to cross-functional stakeholders.
• Build AI-native monitoring for program-wide KPIs to support leadership reporting.
• Lead special projects requiring structured thinking and cross-team collaboration.

Requirements

• 4+ years of experience managing processes with tight turnaround times.
• Must be located within the 50 U.S. states.
• Strong written and verbal communication skills.
• Ability to analyze data using database query tools and proficiency with spreadsheets (e.g., Google Sheets).
• Curiosity and comfort experimenting with emerging AI technology and LLMs.

Nice to have

• Experience in healthcare operations or quality assurance.

Culture & Benefits

• Employer-sponsored health, dental, and vision plans with low or no premiums.
• Generous paid time off and parental leave program.
• $100 monthly mobile or internet stipend.
• Stock options for all employees and bonus eligibility.
• 401K retirement program.