HealthFirst

Senior Forecast Planning Analyst

HealthFirst · Full Time · 5 hours ago

HealthFirst

🌎 United States 💵 $61300 - $99620 per year ⭐ 2-5 yrs exp 💼 Others

The analyst leads end-to-end forecasting and capacity planning for multichannel contact center operations, ensuring strategic alignment and performance oversight. They translate demand forecasts into actionable staffing strategies while driving continuous improvement in models and methodologies.

recruiting excel forecasting data-analysis communication reporting operations onboarding staffing leadership hiring documentation

APPLY

Sr QA Analyst, Claims

HealthFirst · Full Time · 4 days ago

HealthFirst

🌎 United States 💵 $148K - $165K per year ⭐ 5-10 yrs exp 💼 Legal

The Sr QA Analyst drives in-sprint automation and owns the roadmap for automation solutions to ensure high-quality claims processing outcomes. They collaborate with cross-functional teams to define testing strategies, develop reusable components, and mentor automation engineers.

test-automation recruiting qa agile communication onboarding hiring testing

APPLY

Appeals and Grievances Clinical Specialist

HealthFirst · Full Time · 7 days ago

HealthFirst

🌎 United States 💵 $73400 - $120K per year ⭐ 2-5 yrs exp 💼 Healthcare

The specialist is responsible for the end-to-end investigation and resolution of clinical appeals and grievances, ensuring compliance with state and federal regulations. This includes researching medical necessity, preparing cases for Medical Director review, and managing a high-volume caseload.

recruiting medical communication operations onboarding hiring documentation organization compliance

APPLY

CCO Service Agent - 100% Remote

HealthFirst · Full Time · 18 days ago

HealthFirst

🌎 United States 💵 $34900 - $54570 per year ⭐ 2-5 yrs exp 💼 Support

The Service Agent supports Contact Center Operations by addressing member and provider inquiries and resolving complaints across various lines of business. They are responsible for maintaining high customer experience standards, meeting performance KPIs, and ensuring HIPAA compliance.

recruiting customer-service call-center medical communication customer-relationship microsoft-office operations onboarding hiring compliance

APPLY

Appeals & Grievances Clinical Specialist

HealthFirst · Full Time · a month ago

HealthFirst

🌎 India, United States 💵 $73400 - $120K per year ⭐ 2-5 yrs exp 💼 Healthcare

The specialist is responsible for investigating and responding to clinical appeals and grievances from members and providers. This includes classifying cases, collaborating with other departments, and participating in regulatory site visits.

APPLY

Vendor Partner Specialist - Contact Center Operations

HealthFirst · Full Time · 2 months ago

HealthFirst

🌎 United States 💵 $51000 - $80070 per year ⭐ 2-5 yrs exp 💼 Support

The Vendor Partner Specialist manages relationships with external vendors to ensure service level agreement adherence and quality auditing. They act as a liaison between department leaders and vendors to coordinate workflow, training, and process improvements.

APPLY

CCO Service Agent – Language Requirement

HealthFirst · Full Time · 3 months ago

HealthFirst

🌎 United States 💵 $34900 - $54570 per year ⭐ 0-2 yrs exp 💼 Support

The Service Agent supports Contact Center Operations by addressing member and provider inquiries and resolving complaints across various lines of business. They are responsible for maintaining high customer experience standards, preventing dis-enrollments, and ensuring HIPAA compliance.

APPLY

Medical Peer Reviewer

HealthFirst · Full Time · 4 months ago

HealthFirst

🌎 United States 💵 $122K - $188K per year ⭐ 2-5 yrs exp 💼 Healthcare

The Medical Peer Reviewer consults on medical necessity within utilization management, ensuring adherence to internal and external regulations by assessing authorization requests and claims payments based on medical records. This role involves rendering determinations within regulatory timeframes, maintaining productivity standards, and collaborating across various medical and management departments.

APPLY