Healthcare Analyst - Provider Engagement & Innovation

3+ months agoNew York, NY

Hello! Thank you for considering Healthfirst for your next career opportunity.

Who we are:

Healthfirst was founded by a collection of major healthcare systems in the New York area to emphasize high quality of care, and better patient outcomes. We have grown into New York's largest not-for-profit health insurer, and cover over 1.6 million members in New York City and on Long Island, as well as in Westchester, Sullivan, Orange, and Rockland counties. Healthfirst accomplishes this all while following our value-based model, and collaborating with our hospital sponsors and provider partners through our provider delivery system.

More about the team, and the role:

The provider network is an integral part of our business. The Delivery System & Engagement - Provider Engagement Analytics team is unique that looks for ways to optimize the provider network and enhance the value-based model. We analyze providers' performance to identify improvement opportunities and collaborate across different functional teams in Healthfirst to build and monitor processes and initiatives. As a healthcare analyst you will be serving a critical role in identify opportunities and modeling impact of different initiatives.

You will be:

  • Analyze the financial performance of all Healthfirst products, identify favorable and unfavorable trends, develop recommendations to improve trends, communicate recommendations to management.
  • Create financial models to evaluate the impact of provider reimbursement changes.
  • Gather data and conduct ad-hoc analyses as directed by other Finance Analysis team members and assist with the development and presentation of analytical data reports.
  • Support Financial Analysis projects related to medical cost reduction initiatives.
  • Support Medical Management by assisting with Return on Investment (RoI) analyses for vendors to determine if their financial and clinical performance is achieving desired results.
  • Keep abreast of New York Medicaid and Medicare reforms and their impact on Healthfirst and their owner hospital performance. | Additional duties as assigned

Minimum Requirements:
  • Bachelor's degree or higher from an accredited institution with a concentration in Finance, Accounting, Business, or Healthcare Administration - Experience in modeling financial impact of provider reimbursement changes.
  • Self motivated, creative problem solver who can work independently and collaborate through strong communication and interpersonal skills.
  • Strong project management experience and ability to handle multiple projects in a fast paced environment.
  • Demonstrated understanding of key managed care concepts and provider reimbursement principles such as risk adjustment, capitation, FFS (Fee-for-Service), Diagnosis Related Groups (DRG's), Ambulatory Patient Groups (APG's), Ambulatory Payment Classifications (APC's), and other payment mechanisms.

Preferred Qualifications:
  • A Bachelor's or Master's Degree in Healthcare Administration or Healthcare Finance
  • Previous work experience within the healthcare industry with risk adjustment (Managing vendors, operating workstreams) or analytics (Hospitals, IPAs, Healthcare vendors)
  • Experience using Data Visualization tools like Tableau, Qlik View, Power BI

Please note: Since we care so greatly about our employees' and members' wellbeing, Healthfirst is moving to a fully vaccinated in-office environment. You must be vaccinated to work in our offices, even if you are partially remote. If you are selected to interview for this role, we will explain our vaccination policy and ensure you are comfortable moving forward with further interviews based on your work location.

WE ARE AN EQUAL OPPORTUNITY EMPLOYER. Applicants and employees are considered for positions and are evaluated without regard to race, color, religion, gender, gender identity, sexual orientation, national origin, age, genetic information, military or veteran status, marital status, mental or physical disability 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.

EEO Law Poster and Supplement

All hiring and recruitment at Healthfirst is transacted with a valid "" email address only or from a recruitment firm representing our Company. Any recruitment firm representing Healthfirst will readily provide you with the name and contact information of the recruiting professional representing the opportunity you are inquiring about. If you receive a communication from a sender whose domain is not, or not one of our recruitment partners, please be aware that those communications are not coming from or authorized by Healthfirst.  Healthfirst will never ask you for money during the recruitment or onboarding process.

Job ID: healthfirst-R008748