Correspondence and Clinical Process Manager

Location: United States; fully remote with approximately 10% travel

Salary: $110,000–$123,000 annually, plus benefits and bonus

Company

hirify.global develops a clinical intelligence platform and AI-powered healthcare solutions that streamline payer-provider decision-making, utilization management, payment accuracy, and clinical validation.

What you will do

• Support clinical process improvement initiatives and new delegated client implementations.
• Monitor performance against client service-level agreements and help influence operational results.
• Conduct root cause analyses and support remediation planning and execution for process variation, including corrective action plans.
• Assess clinical operations processes against work instructions, policies, procedures, regulations, and accreditation requirements.
• Develop and update work instructions while optimizing correspondence processes and template tracking.
• Collaborate with product and analytics teams to apply technology, automation, and data insights to clinical operations.

Requirements

• Bachelor's degree in healthcare and active clinical licensure in the state of residence; RN, PT, OT, or SLP backgrounds are considered.
• At least 3 years of experience in utilization management operations.
• Working knowledge of healthcare regulations and accreditation requirements, including CMS, Medicaid, and JCAHO.
• Proficiency with Excel or Google Sheets for data analysis and quantitative decision-making, plus comfort building presentations in PowerPoint or Google Slides.
• Hands-on experience implementing process improvements and strong communication, stakeholder management, and influencing skills.
• Ability to work independently as an outcomes-oriented problem solver in ambiguous, fast-paced environments.

Nice to have

• Experience developing policies, procedures, or work instructions.
• Leadership experience in healthcare operations, payer/provider communications, or utilization management.
• Experience with automation technologies, workflow platforms, or AI/ML in utilization management.
• Lean Six Sigma certification, change management experience, or experience translating operational needs into business requirements.

Culture & Benefits

• Fully remote work arrangement with approximately 10% travel.
• Medical, dental, vision, life, disability insurance, Employee Assistance Program, flexible spending account, and health savings account.
• 401(k) retirement plan with company match.
• Flexible time off and company holidays.
• Up to 14 weeks of paid parental leave and pet insurance.
• Supportive, inclusive, growth-oriented environment focused on empathetic and collaborative work.

Hiring process

• Preliminary phone screening with Talent Acquisition.
• Interview with the hiring manager.
• Behavioral interview round or rounds.