Healthfirst

Claims Configuration Analyst

NY  |  Req ID: R019285

Duties & Responsibilities:Assist in the on-going evaluation of configuration for new and existing claims business rules including member benefits, claims editing, reference data and system functionality within the claims processing system.Analyze explanation of coverage documents to assist...

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Data Analyst, Healthcare Analytics, Hybrid NY

NY  |  Req ID: R019034

This is a hybrid opportunity with a work schedule consisting of reporting to our office 3 days per week located at 100 Church Street, NYC.Duties and ResponsibilitiesLeverage leading analytical tools to generate insights that facilitate key decisions by department leadershipCreate accurate reports...

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Director, Clinical Performance Optimization

NY  |  Req ID: R018962

Responsibilities include:·       Drive initiatives and activities to enhance performance of the department with an emphasis on efficiency and effectiveness.·       Develops and leads a team to drive optimization across the Clinical Operations Landscape (including UM, CM, behavioral health,...

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Director, DevOps

FL  |  Req ID: R019354

Healthfirst has embraced a Scaled Agile Methodology for planning and executing virtually all change initiatives, including Infrastructure.  The Agile approach favors leadership over command-and-control management.  We use Agile planning methods to sequence work and manage dependencies and...

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Healthcare Analyst

NY  |  Req ID: R019364

Analyze the financial performance of all Healthfirst products, identify favorable and unfavorable trends, develop recommendations to improve trends, communicate recommendations to management.Create financial models to evaluate the impact of provider reimbursement changes.Gather data and conduct...

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Healthcare Analyst (Provider Reporting)

NY  |  Req ID: R019266

Duties/Responsibilities:Monitor costs and revenue trends for Provider Organizations.Work cross-departmentally to determine provider performance results, package data into key points and visuals, and communicate to internal leadership and external stakeholders. Support contract analytics and fee...

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Healthcare Financial Analyst | Hybrid NY

NY  |  Req ID: R019516

Duties/Responsibilities:Provide support for the Hospital Organizations performance improvement work groups.Monitor costs and revenue trends for Hospital Organizations and assist in understanding trendsUnderstand and analyze impacts of new program changes.Responsible for creating, modifying, and...

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Manager Product Analytics, Medical Economics

NY  |  Req ID: R019264

Scope of Responsibilities:Monitor cost and utilization trends, provide concise insight into the root cause drivers, and develop potential remediation opportunities.  Provide data driven analysis to Finance, Claims, Medical Management, Network, and other departments to enable critical decision...

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Principal Cloud Database Engineer - Remote

FL  |  Req ID: R017983

Duties and Responsibilities:Database Design and Implementation: Design, develop, and implement cloud-based database solutions in collaboration with development teams. Create database schemas, tables, and indexes to support efficient data storage and retrieval.Cloud Database Administration:...

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Senior Data Analyst, Medical Economics and Medical Cost, Hybrid NY

NY  |  Req ID: R019033

Duties and ResponsibilitiesValue new medical cost initiatives, applying financial modeling expertise and using independent judgement to determine the best methods and approaches to calculate accurate estimates of program savings.Provide data driven analysis to Finance, Claims, Medical Management,...

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Senior Manager, Audit and Compliance Analytics, Hybrid NY

NY  |  Req ID: R018926

Hybrid Work Schedule consists of reporting to our 100 Church Street office location 3 days a week.Scope of Responsibilities Responsible for the overall strategy and delivery of high priority analytics supporting key enterprise and department initiativesOversees the development and implementation...

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Senior Manager, Performance Improvement

NY  |  Req ID: R019587

Duties & Responsibilities:Identify and/or direct process improvement opportunities and provide preliminary benefit/financial valuation for project prioritizationLead cross functional teams in successful completion of assigned projects; generate solutions to complex problems through...

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ServiceNow - Principal Engineer

FL  |  Req ID: R018193

Chief technical designer for ServiceNow code and architecture, responsible for overall ServiceNow code qualityProvide day-to-day administrative ServiceNow support, including advanced support via troubleshooting, implementing bug fixes and root cause analysisMonitor health, usage, and overall...

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Sr Healthcare Analyst

NY  |  Req ID: R017672

Job Description:Produce and manage annual hospital performance review packets.Monitor costs and revenue trends for hospitals and identify route cause of developing trends.Understand and analyze impacts of new program changes such as new benefits or new populations.Prepare monthly analysis for...

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Sr Healthcare Analyst

NY  |  Req ID: R019049

~Hybrid Work Schedule consists of reporting to our 100 Church Street, NYC office 3 days per week~Scope of ResponsibilitiesLeverage leading analytical tools to generate insights that facilitate key decisions by department leadership.Create accurate reports or insightful and user-friendly...

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Sr Healthcare Analyst - Medical Economics

NY  |  Req ID: R018888

Duties & Responsibilities:Value new medical cost initiatives, applying financial modeling expertise and using independent judgement to determine the best methods and approaches to calculate accurate estimates of program savings.Provide data driven analysis to Finance, Claims, Medical...

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Sr Mulesoft Application Developer

NY  |  Req ID: R019586

Duties & Responsibilities:Collaborates within the Agile framework, fosters a team approach to software development (review code) and delivery (release activities and postproduction validations)Apply API-led connectivity concepts to business initiatives to help program achieve their...

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Sr. Workforce Effectiveness Data Analyst

FL  |  Req ID: R019463

Leverage leading analytical tools to generate insights that facilitate key decisions by department LeadershipDevelop repeatable analytics aimed at department and Executive Leadership that provide insights into the health and performance of the department.Leverage available data to develop...

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Team Lead Operations • Enrollment & Billing

FL  |  Req ID: R019026

**This position is Hybrid NY or Hybrid FLDuties & Responsibilities:Provide day-to-day supervisory leadership to Analytics TeamManage the teams’ progress on various report requests, projects, and testing to ensure quality and deadlines are met  Provide continuous coaching and training to...

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