Jobs at Healthfirst, Inc

Lead strategic, cross-functional performance improvement initiatives to optimize clinical and operational performance, build organizational capability, and deliver measurable financial and customer outcomes through process optimization, automation, AI-enabled solutions, change management, and stakeholder engagement.

Manage claims-related modernization initiatives, oversee project reports, collaborate with IT, and implement process improvements in a healthcare setting.

Serve as Product Owner for Provider Data Operations: define product vision, prioritize and maintain backlog, author and accept user stories, create UAT test cases, support Agile/Scrum processes, collaborate with cross-functional and stakeholder teams, drive process improvements, and ensure delivery of high-quality features. Hybrid role (Tues/Wed/Thurs in NYC).

The Senior Product Specialist leads product initiatives, collaborates with various teams, and manages documentation for successful execution of projects in the product portfolio.

The Support Coordinator assists care managers with non-clinical tasks, provides customer service to members and providers, manages authorizations, and ensures compliance with guidelines.

The Director, Workforce Analytics leads the workforce analytics function, transforming data into insights to optimize talent strategy and support organizational goals through analytics and reporting.

Support the Provider Risk Analytics team by performing data analysis and projects to monitor cost and revenue trends, identify improvement opportunities, model impacts for provider organizations, attend provider meetings, and learn value-based care and risk modeling.

Lead out-of-network contracting strategy and negotiations, manage provider relationships, ensure regulatory and contractual compliance, collaborate with legal/finance/clinical teams, analyze claims and reimbursement trends, develop policies and playbooks, and manage/direct a contracting team to optimize access and financial performance.

The Peer Support Specialist models recovery and supports members dealing with mental health and substance use, manages a caseload, facilitates care coordination, and collaborates with multidisciplinary teams.

The AVP of Community Engagement leads strategies to enhance community health, improve member health outcomes, and operationalize initiatives aligning with marketing and enterprise objectives. Responsibilities include managing a team, executing community strategies, tracking outcomes, and building partnerships with local organizations.

The Senior Project Manager leads complex enterprise transformation projects in healthcare, ensuring strategic alignment, operational improvements, and compliance while collaborating with various stakeholders.

The Senior Product Strategy Specialist leads product initiatives for Medicaid Products, coordinating with cross-functional teams, ensuring accurate documentation, and driving strategic execution.

Lead strategy, design, and execution of HR technology solutions, driving data architecture, governance, integrations, vendor management, reporting/analytics, AI use cases, and team development to improve employee experience and operational outcomes.

The Senior Network Account Manager develops provider networks, enhances provider satisfaction through education, and implements initiatives for healthcare delivery improvement, while ensuring compliance and effective communication within the team.

The Peer Support Specialist supports members with mental health and substance use issues, coordinating care and linking them to resources while modeling recovery through lived experience.

Manage and develop an Ancillary provider network ensuring Healthfirst members receive quality care while resolving claims issues and facilitating provider education.

The Senior Manager, HR Technology & Integration oversees the HR technology infrastructure, ensuring integration, configuration, and data flow across platforms, while leading a small team. They enhance system reliability and efficiency, monitor integrations, and resolve technical issues.

The Director of Performance Improvement leads initiatives to enhance business processes and productivity, manages staff, and collaborates on strategy development.

The Senior Social Media Manager will strategize and execute social media campaigns, analyze data, manage content development, and lead a team to enhance brand engagement.

The Coding Educator trains providers on diagnosis coding compliance, audits clinical documentation, manages inquiries, and develops educational materials to improve coding accuracy.