Search the 19 jobs at Healthfirst, Inc

The Team Lead, Workforce Systems & Reporting is responsible for leading a team of analysts, ensuring operational effectiveness, coordinating workflows, analyzing data, and implementing reporting tools. They will also manage testing and project goals while recommending improvements based on analyses to enhance the performance of the Contact Center Operations.

The Senior Recruiter will lead high-volume recruitment for Call Center Operations, utilizing innovative sourcing techniques and technology. Responsibilities include developing talent sourcing strategies, leveraging CRM platforms, acting as an employment brand ambassador, and tracking ROI on sourcing efforts. The role emphasizes building strong relationships with hiring managers and efficiently managing multiple requisitions.

The Manager, Network Account Management will oversee the Account Team, focusing on building relationships with key providers to enhance engagement, quality, and profitability. Responsibilities include strategic planning, negotiating provider agreements, coordinating internal resources, and implementing projects while understanding market trends.

The Team Lead, Operations Analytics will manage the analytics team, supervise daily activities, oversee report generation processes, collaborate with business partners to improve processes, conduct root cause analysis, and ensure quality outcomes while providing training and mentorship to the team.

The Actuarial Analyst will support Medicare products analysis including pricing, forecasting, data analytics, and performance monitoring. Key tasks involve handling premium and claims data, assisting in the Medicare bid process, and conducting various analyses on Medicare products.

The Senior Social Media Manager is responsible for developing and implementing a comprehensive social media strategy, analyzing performance data, managing content development, overseeing community management, and staying up-to-date with social media trends. This role requires strong leadership, communication, and analytics skills to drive brand awareness and engagement in the social media space.

The Specialist will assist in executing and improving retail strategies for member and prospect experiences, manage day-to-day operations, support community engagement, and enhance operational standards through systems, processes, and training development. Responsibilities include coordinating with stakeholders, data collection, project management, and maintaining Salesforce for performance tracking.

The Workforce Systems & Reporting Analyst focuses on enhancing operational efficiency in contact center systems by gathering data, making recommendations, developing project plans, and improving business processes. Responsibilities include providing status reports, collaborating with business units, performing systems testing, and supporting leadership initiatives to meet daily KPIs.

The Quality Assurance Auditor conducts internal quality assurance audits of operational processes, investigates appeals and grievances, and analyzes errors. They provide feedback for improvement and document findings, all while working remotely and supporting departmental policies and procedures.

The Sr Manager of Data Products will lead a team to create a sophisticated data platform and solutions. Responsibilities include defining the vision and objectives, managing the product backlog, coordinating with stakeholders, and ensuring best practices for performance and compliance are followed.

The Support Coordinator assists care/case managers with non-clinical tasks including creating cases, providing telephonic outreach, handling member mailings, and faxing clinical requests. They are part of a dedicated clinical team and may have additional responsibilities.

The Bilingual Retention Coordinator (Spanish) provides telephonic support to members and families regarding financial entitlements related to Medicare and Medicaid. Responsibilities include managing inbound and outbound calls, educating clients on programs, scheduling appointments, and documenting interactions in Salesforce while complying with regulations and maintaining confidentiality.

The Community Engagement Specialist will connect communities to health resources, manage relationships with community partners, track and evaluate engagement efforts, and organize community events to promote well-being and health equity.

The Senior Manager for the Migration team oversees migration initiatives, leading a team of technical professionals and managing project timelines. Responsibilities include developing strategies, ensuring technical requirements are met, troubleshooting issues, and providing updates on Agile deliverables while conducting post-migration reviews for improvements.

The Performance Support Specialist assists in resolving customer complaints, maintaining complaint tracking systems, and reaching out to members. They provide support to internal and external business partners, make recommendations for process improvements, and manage inquiries from various departments. This role requires excellent customer service skills and the ability to multitask efficiently.

The Principal Cloud Database Engineer designs, implements, and manages cloud-based database solutions, ensuring high performance, data integrity, and security. Responsibilities include database administration, performance tuning, automation, and collaboration with development and infrastructure teams. This role also involves capacity planning, monitoring, and compliance with data protection regulations while leading technical initiatives and supporting operational excellence.

The Sr Operations Coding Analyst is responsible for making complex coding decisions on claims and appeals, guiding junior analysts, and ensuring compliance with coding guidelines and policies. They lead improvements in claims editing processes, monitor performance, and resolve provider disputes, utilizing independent judgement and collaboration with other departments and vendors.

The Support Coordinator assists care/case managers with non-clinical tasks, provides telephonic outreach to members and providers, manages case documentation, and handles member inquiries and authorizations. They communicate issues and monitor screenings to ensure effective intervention and may have additional departmental responsibilities.

The Support Coordinator assists care managers with non-clinical activities including case creation, telephonic outreach to members and providers, handling mailings, and managing a caseload. They document member information and communicate needs while ensuring compliance with procedures. The role involves scheduling appointments and facilitating authorizations and referrals.