Jobs at Healthfirst, Inc

The Internal Audit Analyst assesses and evaluates internal controls, supports compliance with SOX, and manages audit documentation and testing.

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.

Develop and maintain multichannel forecasts and capacity plans for a contact center, validate data inputs, track forecast performance versus actuals, produce reporting and KPIs, support scenario analysis and SOPs, and partner with operations and BPOs to translate demand into staffing plans and escalate risks.

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

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

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 Senior Product Specialist leads initiatives, collaborating with teams to enhance products within the Healthfirst portfolio while managing project execution and communication across departments.

The Manager, Enrollment & Billing oversees billing and enrollment processes, ensures operational efficiency, manages team performance, and implements improvements. They collaborate across departments to maintain data integrity and meet deadlines.

The Senior Specialist coordinates product initiatives by collaborating with cross-functional teams, managing project schedules, and analyzing market trends while supporting senior management.

The Product Owner will drive product strategy and execution within an Agile environment, coordinating between operations and technology teams to enhance business processes and customer satisfaction.

The AVP of Community Engagement leads Healthfirst's community health initiatives, driving partnerships, enrollment, and retention strategies to enhance member health and improve community well-being.

Lead cloud infrastructure strategy and standards across public and private clouds. Design, build, and automate systems using IaC and scripting, mentor engineers, serve as SME for complex incidents, support hybrid cloud technologies, enforce governance and security best practices, and drive resiliency and operational excellence.

Lead enterprise process architecture for AI-enabled workflows: establish decomposition methods, standards, reusable process modules, human-agent patterns, governance, and partner with delivery teams to ensure scalable, observable, compliant, and optimizable process designs that meet business and customer outcomes.

Lead design, development, testing, and delivery of Qlik-based dashboards, reports, and healthcare applications. Build data extracts, optimize Qlik apps, develop NPrinting reports, write specifications and code, use Agile tools, support deployments, and train/assist end users and QA.

Front-line community office coordinator who greets and triages members, registers and educates portal users, audits applications, manages office inventory and mail, tracks activity metrics, escalates issues to Sales/IT/Billing, trains staff on common errors, and opens/closes the office while protecting member privacy and PHI.

Lead enterprise information architecture by defining and executing the information management and enterprise data architecture roadmaps. Partner with business and IT stakeholders to design data models, integrate data stores/EDW/ODS, enable analytics and BI, and drive governance, data integration, and deployment practices. Mentor teams, influence cross-functional decisions, and support transformation efforts aligning data assets with corporate strategy.

Lead development and execution of Medicaid member experience strategy, driving journey design, personalization, segmentation, and engagement. Partner cross-functionally to translate insights and VOC into roadmaps, manage a portfolio of initiatives, define metrics, and lead a small strategy team to improve member engagement, satisfaction, retention, and outcomes within regulatory constraints.

The Director manages benefit configuration, ensuring compliance and effective structure. Oversees team performance and collaborates across departments for operational efficiency and regulatory adherence.

The Director of Utilization Management leads clinical operations for UM teams, ensuring compliance and quality care while driving process improvement and technology integration.