Manager, Quality Improvement, HEDIS Audit

Location: Remote anywhere in the United States

Salary: $87,700–$157,800 per year

Company

hirify.global is a diversified national healthcare organization serving 28 million members and focused on improving community health.

What you will do

• Lead the state HEDIS audit and regulatory submission portfolio within the Quality Audit & Submission team.
• Oversee state HEDIS, Medicaid quality reporting, and regulatory programs, including state-specific audit requirements.
• Act as an escalation point for health plans, auditors, and internal partners.
• Review reports, records, directives, and submission data to support compliance with government, state, federal, and certification requirements.
• Improve quality improvement procedures and practices while documenting, investigating, and resolving complaints and appeals.
• Monitor costs and participate in budget preparation and management reporting.

Requirements

• Bachelor’s degree in a related field or equivalent experience.
• At least 3 years of clinical, quality management, or healthcare-related experience.
• At least 1 year of recent quality improvement and supervisory experience in a healthcare environment, preferably managed care.
• Strong knowledge of HEDIS, NCQA requirements, Medicaid quality reporting, and healthcare regulatory submissions is preferred.
• Experience leading complex audit or regulatory programs with multiple concurrent deadlines is highly preferred.
• Must be authorized to work in the United States without current or future employment-based visa sponsorship.

Nice to have

• Experience in managed care.
• Formal certification in quality improvement, risk management, or a related field where required by the applicable state.

Culture & Benefits

• Remote work from anywhere in the United States with a flexible approach to work schedules.
• Health insurance, 401(k), and stock purchase plans.
• Tuition reimbursement, paid time off, and holidays.
• Competitive pay and potential additional incentive compensation.
• Commitment to equal opportunity, diversity, and fair consideration of qualified applicants.