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Chief Operating Officer

NY Req ID: R019836 Hybrid
Responsible for the daily operations of the organization Plans, directs, conducts, and evaluates operational activities of the organization Develops, recommends, and oversees implementation of objectives, plans and policies for the organization; Directs the organization’s operations to ensure...
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Claims Implementation Analyst

FL Req ID: R018713 Remote
Duties & ResponsibilitiesAnalyze contract terms, prepare fee schedules and accurately document file changes into the claims processing system Research and identify published updates to payment methodologies, fee schedules and claims editing policies from Medicare, Medicaid, and third-party...
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Claims Supervisor

NY Req ID: R018726 Hybrid
•Responsible for the oversight of claims processing workflow from time of receipt to final adjudication. Review status and inventory reports to ensure acceptable levels are maintained. Alert management to issues affecting timeliness and accuracy of processing and develop plans to...
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Clinical Director

Req ID: R019818 Remote
Duties/Responsibilities:Examines provider claims and service authorizations for completeness, accuracy, and medical necessity and proposes resolutions per internal and regulatory processes.Communicates to relevant teams and providers any claims/ authorization inaccuracies found along with...
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Confidential hire Acturail

NY Req ID: R018762 Hybrid
Duties and Responsibilities:Monitoring performance on all lines of business and update forecasts as appropriateResponsible for EMR actual versus budget/forecast variance analytics in each monthly closeBuild and maintain Healthfirst’s quarterly forecast models.Responsible for Medical Cost trend /...
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Confidential Test Manager

Req ID: R016499 Remote
Identify, assess and screen candidates for requisitions or job groups within specific business areas. Develop robust sourcing strategies that will deliver robust talent pipelines Review candidates that have applied to requisitions to identify those with the qualifications to be phone...
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CW Test

NY Req ID: R016476
Communications: Effective facilitator in client management and/or technical discussions, in developing and delivering presentations, and clearly communicating issues to SMC Leadership. Client Delivery:  Take ownership in delivering high quality, on budget work, with high client...
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Data Analyst - Demos

NY Req ID: R018702 Hybrid
Duties and Responsibilities:Supports performance improvement projects to meet deadlines and expected goals/ deliverables.Leads data analysis required to support process improvement efforts.Partners with internal Business Analysts to ensure appropriate data is utilized.Provides ad-hoc analyses to...
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Data Engineer

Req ID: R019821 On Location 1101 Greenwood Blvd, Lake Mary, FL
Duties and Responsibilities:Finds trends in datasets and develops workflows and algorithms to make raw data useful to the enterpriseDesigns and implements standardized data management procedures around data staging, data ingestion, data preparation, data provisioning, and data destruction...
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Data Engineer

NY Req ID: R020130 Remote
The Data Engineer will be responsible for finding trends in datasets and developing workflows and algorithms to help make raw data more useful to the enterprise. He or she will also be responsible for createing data acquisition strategy and develops data set processes.Designs and implements...
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Data Entry Clerk

FL Req ID: R018701 Hybrid
Duties & Responsibilities:Check claims and or service form statuses using Healthfirst systems; retrieve and store documents from document imaging system as neededResponsible for handling departmental correspondence/mailScan & document all incoming correspondence into the internal document...
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Data Entry Clerk

FL Req ID: R016443 Hybrid
Duties & Responsibilities: Check claims and or service form statuses using Healthfirst systems; retrieve and store documents from document imaging system as needed Responsible for handling departmental correspondence/mail Scan & document all incoming correspondence into the internal document...
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Data Platform Architect

NY Req ID: R020718 Remote
Key Responsibilities:Architect and Design the Data Lakehouse: Lead the design and implementation of a scalable and secure Data Lakehouse on AWS, including data storage and compute layers.Storage Solutions: Design and implement storage solutions using AWS services like S3, Iceberg,Integrate...
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Data Scientist

MT Req ID: R018728 Remote
Duties/Responsibilities:Build lasting partnerships with stakeholders to deliver solutions that positively impact our members and providersHarness the potential of complex, disparate data sources to create robust solutionsUse statistical modeling and machine learning to predict key outcomes and...
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Data Scientist

NY Req ID: R016411 Remote
Duties/Responsibilities: Build lasting partnerships with stakeholders to deliver solutions that positively impact our members and providers Harness the potential of complex, disparate data sources to create robust solutions Use statistical modeling and machine learning to predict key outcomes...
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Data Scientist

Req ID: R020131 Hybrid
Duties and ResponsibilitiesLearn and interact with both legacy data systems and newly curated datasets hosted on Amazon Web ServicesCollaborate closely with client Relationship Managers who will hand off projects, set the priorities and inspect the output of the final analysisEffectively blend...
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