RN, Quality Assurance Professional (Healthcare)

Location: Remote nationwide within the United States; occasional travel of up to 5% to team meetings or hirify.global offices may be required. Working hours are Monday–Friday, 8:00 AM–5:00 PM Eastern Time.

Salary: $65,000–$88,600 per year, plus eligibility for a bonus incentive plan.

Company

hirify.global is a U.S. healthcare company providing insurance services and CenterWell healthcare services to members, families, military personnel, and communities.

What you will do

• Serve as the clinical subject matter expert for Internal Audit engagements across CenterWell, care management, utilization management, and other healthcare operations.
• Provide clinical insight during audit planning, testing, and reporting.
• Review clinical documentation, operational workflows, and quality management activities.
• Assess process controls and compliance with regulatory, contractual, and organizational requirements.
• Identify risks and recommend improvements to compliance, care quality, and operational performance.

Requirements

• Active, unrestricted RN license.
• At least 3 years of clinical nursing experience, including knowledge of care management, utilization management, population health, or healthcare operations.
• Experience reviewing clinical documentation, healthcare processes, and operational workflows.
• Knowledge of healthcare regulations and accreditation standards, including CMS, NCQA, URAC, and applicable state and federal requirements.
• Proficiency in Microsoft Word, Excel, and PowerPoint.
• Strong written and oral communication skills for reporting and stakeholder collaboration.

Nice to have

• Certification such as CPHQ, CCM, CPUM, CIA, or a related credential.
• Experience in managed care or healthcare administration.
• Experience participating in audits, assessments, quality reviews, or compliance monitoring.

Culture & Benefits

• Remote work with occasional travel for training, meetings, or team engagement.
• Dedicated home 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, life insurance, and additional wellness benefits.