Healthfirst Healthcare Analyst in New York, New York


The Healthcare Analyst will support the department, collaborate across the organization, and build relationships with external vendors to optimize the submission of accurate member data to federal and state agencies. The ideal candidate is highly self-motivated and has an interest in a role at the intersection of Healthcare, Finance, and Data Analysis.

  • Conduct analyses to determine data gaps and inaccuracies – and calculate the financial impact of these gaps to Healthfirst.

  • Engage with external vendors to close member data gaps using both provider-facing and member-facing strategies.

  • Develop and maintain ongoing reporting on the success of internal initiatives as well as those supported by external vendors.

  • Identify both positive and negative trends based on reporting and communicate these to key stakeholders.

  • Closely monitor and track spending by external vendors by validating monthly invoices, tracking Actual to Budget performance, and forecasting spending based on trends.

  • Providing support to team members who manage the relationships with the external Risk Adjustment vendors.

  • Additional duties as assigned.

Minimum Qualifications:

  • Experience with public health insurance programs, including Medicare, Medicaid and/or the Affordable Care Act.

  • Ability to reconcile and analyze large data sets to extract key metrics and identify trends.

  • Bachelor's degree from an accredited institution or relevant experience.

  • Proficiency in excel; ability to create complex formulas, manipulate pivot tables, etc.

  • Ability to communicate effectively and work well in a team-oriented environment.

Preferred Qualifications:

  • Bachelor's degree or higher from an accredited institution with a concentration in Healthcare Administration or Finance.

  • Analytical work experience within the healthcare industry (i.e. hospitals, network, ancillary, medical facilities, healthcare vendor, commercial health insurance company, large physician practices, managed care organization, pharmaceutical, behavioral health organization, etc.).

  • SAS/SQL proficiency

  • Experience with federal and state Risk Adjustment programs.

WE ARE AN EQUAL OPPORTUNITY EMPLOYER. Applicants and employees are considered for positions and are evaluated without regard to mental or physical disability, race, color, religion, gender, national origin, age, genetic information, military or veteran status, sexual orientation, marital status or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.

If you have a disability under the Americans with Disability Act or a similar law, and want a reasonable accommodation to assist with your job search or application for employment, please contact us by sending an email to or calling 212-519-1798 . In your email please include a description of the accommodation you are requesting and a description of the position for which you are applying. Only reasonable accommodation requests related to applying for a position within Healthfirst Management Services will be reviewed at the e-mail address and phone number supplied. Thank you for considering a career with Healthfirst Management Services.

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