Provider Data Validation (PDV) Manager (Healthcare)

Location: Remote nationwide within the United States; occasional travel to hirify.global offices for training or meetings may be required.

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

Company

hirify.global is a U.S. healthcare and insurance company serving Medicare, Medicaid, military, family, individual, and community populations through hirify.global and CenterWell services.

What you will do

• Lead, coach, and develop a team of 13 associates responsible for provider education, coding quality, compliance, and operational performance.
• Drive workforce planning, inventory management, workflow optimization, and equitable workload distribution.
• Monitor performance metrics, identify operational risks, and implement data-driven improvement strategies.
• Oversee provider education initiatives focused on coding accuracy, documentation integrity, provider engagement, and audit readiness.
• Maintain documentation quality at 95% or greater and ensure annual coding and provider education initiatives are completed on schedule.
• Optimize Record Insights workflows and partner with operational and technology stakeholders on risk adjustment transformation, analytics, automation, and innovation.

Requirements

• CRC, CPC, CCS, or equivalent medical coding certification.
• At least 2 years of leadership experience in healthcare operations, risk adjustment, coding, provider education, compliance, or a related field.
• Bachelor’s degree or an equivalent combination of education and experience.
• Proficiency with Excel, Power BI, and data analytics tools.
• Ability to work remotely from within the United States and maintain a dedicated workspace that protects member PHI and HIPAA information.
• Home internet must provide at least 25 Mbps download and 10 Mbps upload speeds.

Nice to have

• Experience in risk adjustment, provider data validation, medical coding, provider education, or healthcare compliance.
• Knowledge of CMS risk adjustment programs, audit methodologies, and regulatory requirements.
• Experience using automation, analytics, or AI technologies to improve operational performance.

Culture & Benefits

• Remote work with occasional travel to hirify.global offices for training or meetings.
• 40-hour workweek with paid time off, company and personal holidays, and paid parental and caregiver leave.
• Medical, dental, and vision benefits.
• 401(k) retirement savings plan, disability coverage, and life insurance.
• Whole-person wellness and healthcare decision-support benefits.