Value-Based Programs Lead (Medicaid)

Location: Remote nationwide within the United States; occasional travel to hirify.global offices and onsite meetings may be required, including up to 10% travel. Working hours are Monday–Friday, 8:00am–5:00pm EST.

Salary: $104,000–$143,000 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 with Medicare and Medicaid, families, individuals, military personnel, and communities.

What you will do

• Develop innovative value-based payment models for behavioral health, maternity, specialist, and social determinants of health providers.
• Align model development roadmaps with Medicaid contractual requirements and RFP commitments.
• Analyze financial, utilization, and performance data to identify quality improvement and total-cost-of-care opportunities.
• Design payment logic, performance metrics, benchmarks, and financial terms aligned with segment goals.
• Develop provider reporting packages and monitor model KPIs to improve model performance.
• Collaborate with finance and matrixed teams to model, pilot, scale, and operationalize new VBP solutions.

Requirements

• Bachelor’s degree.
• At least 5 years of experience in managed care operations, provider reimbursement and analytics, and value-based care.
• Expertise in VBP model design and strategy for specialty providers, including pay for performance, bundled payments, accountable care, shared savings, and risk models.
• Expertise in Medicare and/or Medicaid managed care.
• Ability to analyze financial, utilization, and performance data and solve complex business problems.
• Experience working in a matrixed environment, with strong written, oral, presentation, organizational, and interpersonal skills.

Nice to have

• Master’s degree.
• Expertise in VBP financial modeling and impact analysis.

Culture & Benefits

• Remote work from anywhere in the United States with occasional office or meeting travel.
• Dedicated, interruption-free workspace and reliable internet connection required to protect member PHI and HIPAA information.
• Medical, dental, and vision benefits.
• 401(k) retirement savings plan, paid time off, holidays, and paid parental and caregiver leave.
• Short- and long-term disability coverage, life insurance, and bonus incentive eligibility.