Jobs at Alaffia Health

Full-cycle recruiter for Payment Integrity and Managed Services hiring: manage multiple high-volume requisitions, source and screen candidates, coordinate interviews, maintain ATS records, build pipelines, advise hiring managers, and support recruiting events.

Perform inpatient DRG validation audits and clinical reviews of medical records and claims to verify diagnoses, procedures, CCs/MCCs, sequencing, and discharge status. Document defensible findings, ensure compliance with ICD-10 and DRG grouper rules, support QA, and collaborate with operations, product, and engineering to improve audit logic and automation.

The Clinical Payment Integrity Analyst reviews medical claims and patient records, audits for coding violations, and ensures compliance with healthcare payment guidelines.

The Chief of Staff to the CEO manages the CEO's priorities, leads cross-functional projects, and designs scalable processes while driving organizational alignment and investor communications.

The Principal Software Engineer will lead architectural design, mentor engineers, influence technical strategy, and drive AI-augmented development across the platform, ensuring high-impact project delivery in healthcare technology.

As the AI Transformation Lead, you'll drive AI adoption across teams, build AI-powered workflows, and establish foundational systems and metrics for continuous improvement in operations.

Lead architecture and delivery of large, cross-team full‑stack projects; define technical standards and strategy; drive scalability, reliability, and performance; champion AI-augmented development; mentor senior engineers and influence cross-functional decisions to achieve business outcomes.

Lead strategy, growth, and delivery of clinical payment integrity offerings for health plan clients. Build and mentor a high-performing client-facing team, sponsor strategic accounts, partner with Product/Engineering/Sales to shape AI-enabled claims solutions, drive revenue expansion, ensure operational excellence, and represent the company at industry forums.

Review and investigate provider disputes for high-dollar facility claims and itemized bills. Analyze UB-04s, itemized bills, medical records, and audit findings to determine whether Payment Integrity findings should be upheld, modified, or overturned. Apply coding and reimbursement guidelines (CPT, ICD-10, HCPCS, DRGs, APCs), document defensible decisions, manage a high-volume queue, and collaborate with Payment Integrity teams while ensuring PHI/HIPAA compliance.

The Senior Data Engineer is responsible for building AI-driven healthcare automation systems, managing data workflows, and ensuring accurate reporting, particularly in healthcare claims processes.

The Analytics Engineer will develop data models, build dashboards, ensure data reliability, optimize workflows, and foster collaboration to enable data-driven decisions in healthcare operations at Alaffia.

Lead strategy, performance, and scaling of Payment Integrity review programs (IBR, medical record review, DRG validation). Manage managers, set quality/KPI targets, own audit governance, SOPs, capacity planning, client reporting/escalations, and partner with Product/Engineering on AI-assisted workflows.