RN Manager, Quality Improvement & Performance (Healthcare)

Location: Remote in Kentucky; must reside within commuting distance of Louisville or Frankfort. Monday through Friday, 8:00 AM–5:00 PM ET, with quarterly travel to Louisville and additional travel to Frankfort as needed.

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

Company

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

What you will do

• Manage the Kentucky Medicaid Quality Assurance Performance Improvement program across physical and behavioral health.
• Lead member and provider outreach operations and medical record documentation reviews.
• Plan and implement quality improvement initiatives, including Performance Improvement Projects and EPSDT activities.
• Monitor HEDIS, CAHPS, satisfaction, access, and service measures, and track progress toward performance goals.
• Prepare quality reports for internal committees and state regulators, and maintain program descriptions, work plans, and evaluations.
• Lead interdisciplinary workgroups and collaborate with managers and clinical and non-clinical associates.

Requirements

• Active Kentucky Registered Nurse license in good standing without disciplinary action.
• 5+ years of experience in health plan quality improvement and/or quality compliance.
• 5+ years of experience with healthcare quality measures such as HEDIS and CAHPS.
• 3+ years of experience leading member-facing professionals or conducting direct member engagement with demonstrated results.
• 3+ years of experience analyzing data and preparing formal, data-driven reports.
• Comprehensive knowledge of Microsoft Word, PowerPoint, Excel, and Teams.

Nice to have

• Experience with Kentucky Medicaid.
• Bilingual proficiency.
• Certified Professional in Healthcare Quality certification.
• Project management experience.

Culture & Benefits

• Remote work for Kentucky residents with occasional travel to hirify.global offices for meetings or training.
• Dedicated workspace and internet service with at least 25 Mbps download and 10 Mbps upload speeds are required.
• Medical, dental, and vision benefits.
• 401(k) retirement savings plan, paid time off, company and personal holidays, and paid parental and caregiver leave.
• Short- and long-term disability coverage, life insurance, and additional wellness benefits.