Vice President, Medicare Care Management

Location: Remote-MO

Pay range: $188,900–$359,800 per year.

Company

hirify.global connects people with healthcare services and works to improve access, outcomes, and affordability.

What you will do

• Lead the national Medicare Care Management organization, including regional operations, transitions of care, complex care management, duals care management, and specialty programs.
• Develop and execute the enterprise care management strategy aligned with Medicare Advantage growth, quality, utilization management, LTSS, and value-based care.
• Own Model of Care performance, compliance, audit readiness, regulatory outcomes, and standardized clinical workflows across markets.
• Improve clinical outcomes, Star Ratings, member engagement, utilization, and total cost of care by reducing avoidable admissions, readmissions, emergency department use, and post-acute costs.
• Modernize care management through workflow automation, digital engagement, AI-enabled clinical support, analytics, improved clinical platforms, reporting, and interoperability.
• Build and develop regional and functional leadership teams while driving succession planning, organizational design, workforce strategy, and cross-functional partnerships.

Requirements

• Bachelor’s degree and 5+ years of relevant experience.
• Significant experience with Medicare Advantage Care Management operations.
• Expertise in Model of Care requirements, CMS regulations, NCQA standards, and audit readiness.
• Demonstrated success improving clinical outcomes, Star performance, member experience, and medical cost trends.
• Experience leading geographically dispersed teams through transformational change and influencing executive stakeholders.
• Current state RN license preferred; master’s degree preferred.

Culture & Benefits

• Health insurance, 401(k), stock purchase plans, tuition reimbursement, paid time off, and holidays.
• Flexible work approaches including remote, hybrid, field, and office schedules.
• Commitment to diversity, equal opportunity, and improving healthcare access and effectiveness.