Description and Requirements
Key Responsibilities
Operational Optimization
- Analyze provider data workflows to identify inefficiencies, rework, and process gaps.
- Recommend and implement scalable solutions to improve turnaround times and reduce manual effort.
- Support initiatives focused on operational excellence and continuous improvement.
Data Accuracy & Reconciliation
- Perform reconciliation of provider data across systems (e.g., PDM, Atlas, MHS, HRP).
- Identify discrepancies, conduct root-cause analysis, and partner with stakeholders to resolve issues.
- Ensure data integrity, consistency, and alignment across platforms.
QA / UAT & Quality Initiatives
- Participate in QA and UAT testing to validate provider data accuracy and system enhancements.
- Document findings and support issue resolution prior to production deployment.
Reporting & Data Insights
- Analyze provider data trends and develop insights to support informed decision-making.
- Prepare reports and dashboards highlighting risks, performance metrics, and improvement opportunities.
Training & Documentation
- Develop and maintain job aids, standard operating procedures, and training materials.
- Support knowledge-sharing initiatives to improve consistency and team effectiveness.
Minimum Qualifications
- High School Diploma or GED from an accredited institution required; Associate’s or Bachelor’s degree in Business, Healthcare Administration, Data Analytics, or related field preferred.
- Experience working in Microsoft product suite, including Outlook, Word, PowerPoint and Excel
- Advanced Excel skills, including the ability to manipulate and create spreadsheets; standardize reports across multiple worksheets; utilize VLOOKUPs, XLOOKUPs, formulas, and functions; create, interpret, and analyze pivot tables; and apply filtering, conditional formatting, and data validation techniques to generate accurate and meaningful results.
Preferred Qualifications
- Bachelor’s degree in Business, Healthcare Administration, Data Analytics, or related field (or equivalent experience).
- 2–4+ years of experience in healthcare operations, provider data management, or process optimization.
- Experience analyzing data trends and identifying inconsistencies or discrepancies across systems.
- Ability to perform data reconciliation and root-cause analysis to resolve operational issues
- Experience working in cross-functional environments and collaborating with multiple stakeholders.
- Strong written and verbal communication skills, including the ability to document processes and present findings clearly.
- Ability to manage multiple priorities in a fast-paced environment.
- Experience in managed care or provider network operations.
- Familiarity with PDM, provider onboarding workflows, or credentialing processes.
- Experience supporting QA/UAT testing initiatives.
Hiring Range*:
Greater New York City Area (NY, NJ, CT residents): $58,900 - $80,070
All Other Locations (within approved locations): $51,000 - $74,880
As a candidate for this position, your salary and related elements of compensation will be contingent upon your work experience, education, licenses and certifications, and any other factors Healthfirst deems pertinent to the hiring decision.
In addition to your salary, Healthfirst offers employees a full range of benefits such as, medical, dental and vision coverage, incentive and recognition programs, life insurance, and 401k contributions (all benefits are subject to eligibility requirements). Healthfirst believes in providing a competitive compensation and benefits package wherever its employees work and live.
*The hiring range is defined as the lowest and highest salaries that Healthfirst in “good faith” would pay to a new hire, or for a job promotion, or transfer into this role.