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Our Members’ First Line of Support

Healthfirst provides members with quality care. Our Operations team members are the first line of support directly assisting our members. These teams collaborate to streamline processes that drive positive change. Interested in joining our Operations team? Check out our available positions listed below.

Open Positions in Operations

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Change Manager - Modernization (PayDoc)

NY Req ID: R019440 Hybrid
Duties & Responsibilities:Manages assigned initiatives, including workplan development, stakeholder management, change management, implementation, success measurement, and communication of project status to business stakeholders.Partners with IT and Delivery teams in the delivery of technical...
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Claims Implementation Analyst

NY Req ID: R020026 Remote
Duties & ResponsibilitiesAnalyze contract terms, prepare fee schedules and accurately document file changes into the claims processing system Research and identify published updates to payment methodologies, fee schedules and claims editing policies from Medicare, Medicaid, and third-party...
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Manager Enrollment and Billing

NY Req ID: R020160 Hybrid
Duties and Responsibilities:Oversee the enrollment process, ensuring timely and accurate processing of new and modified enrollments, renewals, and terminations.Collaborate with internal teams (e.g., sales, customer service, compliance) to ensure seamless management of members.Monitor ,report, and...
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QA Auditor, Appeals and Grievances

NY Req ID: R020413 Remote
Conduct quality audits of A&G items including grievances, pre-service appeals, and post service appeals utilizing appropriate sources of information; including eligibility, claims, authorizations, service forms, faxes, and any additional information required to complete the request. Analyze...
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