Manager Provider Relations (Medicaid)

Location: Remote, must reside in Illinois; 25% travel throughout Illinois and occasional travel to hirify.global offices may be required. Working hours are Monday–Friday, 8:00 am–5:00 pm CST.

Salary: $86,300–$118,700 per year, plus eligibility for a bonus incentive plan.

Company

hirify.global is a U.S. healthcare company providing insurance and healthcare services for people served through Medicare, Medicaid, and other health programs.

What you will do

• Lead and coach a team of provider relations associates supporting Illinois Medicaid plans.
• Build and maintain long-term relationships with LTSS and other network providers.
• Train team members on policies, platforms, and systems, and assign work to maintain service and quality coverage.
• Coordinate responses to provider inquiries involving claims payment, prior authorizations, referrals, enrollment, and reimbursement.
• Partner with internal departments and external stakeholders to resolve provider issues.
• Monitor state standards and ensure compliance with Illinois managed care contractual requirements, including claims dispute resolution timeframes.

Requirements

• Must reside in Illinois.
• Bachelor’s degree with 4+ years of progressive managed care operations experience, including network management and provider relations; alternatively, a high school diploma with 7+ years of relevant experience.
• 3+ years of Medicaid experience.
• 2+ years of management and team-building experience supervising 5–10 employees.
• Experience with provider types including primary care, FQHCs, hospitals, nursing facilities, HCBS, or LTSS providers.
• Valid state driver’s license, personal vehicle liability insurance with 100/300/100 limits, and availability for 25% travel throughout Illinois.

Nice to have

• Master’s degree.
• Contract negotiation and implementation experience.
• Knowledge of Illinois Medicaid, provider landscapes, and provider networks.

Culture & Benefits

• Remote home-based workstyle with hirify.global office use as needed for collaboration, training, or meetings.
• Dedicated, interruption-free workspace and internet service with at least 25 Mbps download and 10 Mbps upload speeds are required.
• Medical, dental, and vision benefits.
• 401(k), paid time off, company and personal holidays, and paid parental and caregiver leave.
• Short- and long-term disability coverage, life insurance, mileage reimbursement, and other wellness benefits.