Manager Clinical Performance & Quality Coding (Nurse Practitioner or PA)

Location: Hybrid role requiring office attendance three days per week within commuting distance of an eligible U.S. office; offices are available in Wallingford, Tampa, Atlanta, Metairie, Durham, Seven Fields, and Grand Prairie. Hours are Monday through Friday, 8:00 AM–5:00 PM Central.

Company

hirify.global is a Fortune 25 healthcare company focused on improving lives and communities and simplifying healthcare.

What you will do

• Lead quality documentation and value capture for provider medical encounters, ensuring accurate ICD-10 diagnosis coding.
• Serve as the subject matter expert for CMS Risk Adjustment and quality documentation.
• Develop and deliver clinical training on advanced coding and documentation, incorporating coder feedback.
• Align clinical leadership goals and workflows with value capture and documentation initiatives.
• Build performance plans, KPIs, clinical tracking, chart review processes, peer reviews, and remediation procedures.
• Develop workflows for closing HEDIS care opportunities and hire, train, coach, counsel, and evaluate direct reports.

Requirements

• Current, active, valid, and unrestricted nurse practitioner or physician assistant license in the state of residence.
• Master’s degree in Nursing or an equivalent PA qualification.
• At least three years of clinical experience applying appropriate diagnoses in the Medicare HCC model, or an equivalent combination of education and experience.
• Experience with CMS Risk Models.
• Ability to work in an eligible office three days per week and remain within a reasonable commuting distance.

Nice to have

• Management or supervisory experience with direct reports.
• HEDIS experience.
• Clinical data or documentation integrity experience, such as CDEO or CDEI.
• AAPC Certified Risk Adjustment Coder (CRC) certification.

Culture & Benefits

• Hybrid workforce strategy combining regular office collaboration with virtual-work flexibility.
• Merit increases, paid holidays, paid time off, and incentive bonus programs.
• Medical, dental, vision, short- and long-term disability, life insurance, and wellness benefits.
• 401(k) matching, stock purchase plan, and financial education resources.
• COVID-19 and influenza vaccination may be required for certain patient- or member-facing roles, subject to applicable accommodations and laws.