Teams at Healthfirst, Inc

Coordinates clinical documentation and coding projects supporting CMS RADV audits and health plan quality objectives. Responsibilities include improving medical record acquisition, auditing documentation, educating stakeholders on coding practices, analyzing clinical and invoice data, identifying process improvement opportunities, preparing reports and presentations, supporting CMS audit initiatives, and ensuring medical record accuracy, completeness, HIPAA compliance, and regulatory adherence.

Leads delivery of Healthfirst data platforms, applications, pipelines, and capabilities while managing two Agile teams. Translates business requirements into features, oversees planning through production support, and partners with architecture, governance, IT, and stakeholders. Ensures scalable AWS-based solutions, data quality, security, regulatory reporting readiness, incident resolution, and modernization. Mentors multidisciplinary teams and drives operational discipline, reusable patterns, pipeline reliability, and reduction of legacy-tool dependencies.

The Senior Business Analyst supports Provider Data Operations through business process review, data analysis, reporting, testing, workflow improvement, and project coordination. The role develops and maintains statistical reports, identifies defects and operational improvements, validates business requirements, supports testing and implementation, and guides junior analysts. It also ensures compliance with regulatory and corporate requirements while communicating analytical findings and recommendations to management and cross-functional teams.