Healthfirst - IT - Administration, Hybrid work

Seeking a Director of Medical Reviews in New York, NY. This role requires a licensed M.D. or D.O. with Board Certification to conduct medical necessity reviews for utilization management and appeals. You will lead quality improvement initiatives, analyze trends, and collaborate with medical depar...

Lead the Medicare customer experience strategy in this hybrid New York role. Utilize your 10+ years in CX strategy and Medicare Advantage expertise to enhance member journeys. Translate insights into initiatives with cross-functional teams, driving satisfaction and loyalty. Enjoy comprehensive be...

Lead large-scale healthcare transformation initiatives as a Senior Project Manager at Healthfirst. You will modernize Utilization Management through AI, automation, and process redesign. This role requires expertise in complex project delivery within regulated environments. Drive operational effi...

Claims Coding Analyst needed to ensure accurate claims payments by applying CPT, HCPCS, and ICD-10 guidelines. You’ll audit edits, resolve provider disputes, and shape payment policy in Lake Mary or New York. Requires AAPC or AHIMA coding certification. Enjoy medical coverage, 401k, and incentive...

Lead large-scale Utilization Management (UM) transformation initiatives at Healthfirst. This senior role drives modernization through AI, automation, and process redesign to improve efficiency and outcomes. Partner with clinical and tech teams to deliver complex projects with enterprise impact. R...

Seeking an experienced Release Train Engineer to lead Agile program delivery for Infrastructure and Operations in Lake Mary. This role requires 10+ years in IT, with 5+ years in program management or RTE functions, and expertise in SAFe. You will facilitate PI planning, manage cross-functional te...

Seeking an experienced Release Train Engineer (RTE) to lead Agile program delivery for Infrastructure and Operations in Lake Mary. You will facilitate PI planning, manage cross-functional technical teams, and drive SAFe ceremonies. This role requires 10+ years in IT, 5+ years in program managemen...