Payor Authorization Operations Manager

Location: Hybrid, based in Braintree, MA (Boston); must reside in or be willing to permanently relocate to the area.

Estimated base salary: $70,000–$90,000 per year.

Company

hirify.global is a healthcare startup building an AI-powered platform that enables family-led care and helps health plans and government partners improve care delivery at home.

What you will do

• Lead authorization operations for Massachusetts HCBS waiver programs and Long Term Home Health services.
• Own end-to-end prior authorization and reauthorization processes while managing Doc Collectors and Re-Authorization Associates.
• Coordinate with internal teams to resolve authorization issues affecting the revenue lifecycle.
• Handle disputed Medicaid authorizations, appeals, and emergency requests with HCPF and Acentra (Kepro).
• Manage complex Medicaid coordination and dual-eligibility authorization scenarios.
• Build training programs, mentor staff, and establish metrics supporting high approval rates and sub-10-day processing.

Requirements

• 5+ years of Massachusetts Medicaid authorization experience covering LTHH, LTSS, or waiver programs.
• Deep knowledge of the regional LTHH ecosystem, HCPF policies, prior authorization operations, case coordination, and MAPAR systems.
• Strong communication, problem-solving, relationship-building, and stakeholder management skills.
• Experience with CRM systems, data analysis, operational metrics, and compliance requirements.
• Must reside in or be willing to permanently relocate to the Braintree, MA (Boston) area.

Nice to have

• Bachelor’s degree in Healthcare Administration, Business, or an equivalent field.
• Massachusetts Medicaid certification and LTHH authorization training.

Culture & Benefits

• Full-time employment with eligibility for an annual company performance bonus.
• Medical, dental, and vision coverage, including a $0 deductible PPO and company-funded HSA.
• Employer-paid life and disability insurance.
• Paid time off, 10 paid company holidays, and paid parental leave.
• HSA contributions, optional FSA and commuter benefits, and coverage of 401(k) account fees.
• Mission-driven culture emphasizing families first, urgency with precision, resourcefulness, and continuous improvement.

Hiring process

• Employment is contingent on a background check, satisfactory references, and required documentation.
• Applications may be evaluated using automated decision tools, with final hiring decisions reviewed by people.