Assistant Director Clinical Regulatory Operations (Healthcare)

Location: Hybrid, three days per week in office at offices in Burlington, Renton, Spokane, Vancouver, Portland, Medford, Salt Lake City, Boise, Lewiston, or Fargo. Candidates must live within commuting distance or be willing to relocate.

Expected hiring range: $136,000–$184,000 in Oregon, Washington, Utah, and Idaho; $128,144.30–$173,371.70 in North Dakota. Full salary ranges and bonus targets vary by location.

Company

hirify.global is a purpose-driven health care organization focused on making health care easier, more sustainable, and person-focused.

What you will do

• Lead clinical regulatory operations across Utilization Management and Appeals, Care Management, Pharmacy, and Payment Integrity.
• Interpret evolving regulatory requirements and translate them into operational guidance with Regulatory Affairs, Quality, Legal, Compliance, and clinical leaders.
• Design compliance monitoring, auditing, reporting, automation, dashboards, and real-time data visualization frameworks.
• Manage corrective action plans, root cause analysis, remediation, NCQA accreditation readiness, mock audits, and submission preparation.
• Oversee the HSO Rapid Resolution Team and Clinical Review Inter-rater Reliability program.
• Lead a department of 30 FTEs, including hiring, coaching, performance management, budgeting, workforce planning, and project delivery.

Requirements

• Bachelor’s degree in Healthcare Administration, Nursing, Public Health, or a related field; a master’s degree is preferred.
• At least 5 years of leadership experience and 7 years of health insurance or managed care experience in regulatory compliance, quality management, or clinical operations.
• Knowledge of CMS, state, NCQA, HIPAA/privacy, and managed care contract compliance requirements.
• Experience with compliance monitoring, auditing, reporting, policy and procedure development, and data-driven remediation.
• Knowledge of PDSA, Lean, or Six Sigma improvement methodologies and experience aligning processes across teams and lines of business.
• Strong communication, resource management, project management, team leadership, and cross-functional collaboration skills.

Nice to have

• Experience with dashboard development or workflow automation.
• Experience with AI tools and technologies for productivity and decision-making.
• Master’s degree in a relevant field.

Culture & Benefits

• Purpose-driven culture focused on trust, innovation, compassion, and sustainable health care.
• Medical, dental, vision, and mental health coverage, including eligible family members.
• Health savings account contributions, paid time off, and 10 company-paid holidays.
• 401(k) retirement plan with company matching and potential discretionary contributions.
• Paid parental leave, wellness programs, employee assistance support, and commute and parking benefits.
• Work-from-home options are available for most roles subject to wired internet and minimum connection requirements.