Change Manager

Healthfirst; New York (NY); Hybrid; USD 100,000 - 130,000; Full time

Job summary

Healthfirst is looking for a Claims and Provider Payment Modernization Manager to lead initiatives that enhance our claims-related processes. The role requires excellent communication skills and experience in managing complex projects.

The ideal candidate should have a Bachelor's degree and proven competence in driving business automation through change management. This position involves collaboration across multiple departments to ensure seamless transitions from legacy to new systems.

Qualifications

• Bachelor's degree from an accredited institution or equivalent work experience.
• Proven experience driving business automation projects through all phases.
• Change management experience with defining scope and securing buy-in.

Responsibilities

• Manage assigned initiatives, including workplan development and stakeholder management.
• Partner with IT teams in delivery of technical components.
• Lead development of comprehensive process improvement plans.

Skills

Excellent verbal and written communication skills

Driving business automation projects

Change management

Business process management

Agile methodologies

Education

Bachelor’s degree or equivalent work experience

Tools

Scaled Agile (SAFe)

Job description

Claims and Provider Payment Modernization Manager

Represents Healthfirst Operations in support of defined claims-related and provider payment modernization efforts. Provides business oversight of capabilities as they transition from legacy models and systems into new standard configurations and new systems.

Duties & Responsibilities

• Manages assigned initiatives, including workplan development, stakeholder management, change management, implementation, success measurement, and communication of project status to business stakeholders.
• Partners with IT and Delivery teams in the delivery of technical components within existing frameworks and methodologies required by Healthfirst.
• Works across multiple departments in the development of business requirements and associated artifacts by developing a deep understanding of business needs and collaborating closely with peers, leaders, and staff throughout Operations.
• Leads development of comprehensive process improvement and implementation plans, assisting with operational readiness to ensure seamless transition from legacy to new systems.
• Prepares presentations and delivers oversight reports, reporting status to leadership and escalating changes, issues, and risks for resolution as needed.
• Works independently, taking initiative and thinking analytically to drive projects forward.
• Stays current with technology, processes, and best practices, and leverages knowledge to identify opportunities for training and process improvement.
• Develops, formulates, recommends, and implements decisions regarding policy, standards, methods, procedures, and functions.

Minimum Qualifications

• Bachelor’s degree from an accredited institution or equivalent work experience.
• Excellent verbal and written communication skills.
• Proven experience driving business automation projects through phases such as initial business analysis, requirements gathering, development, architecture design, implementation, configuration, integration efforts and ongoing support to end‑users.
• Change management experience, including defining scope, adhering to enterprise SDLC requirements, and securing buy‑in from department management and employees.
• Prior experience working on cross‑functional, transformational or other complex projects.
• Strong understanding of business process management and integration methods and tools.

Preferred Qualifications

• Experience leading large‑scale change initiatives in a health‑plan setting.
• Demonstrated understanding and practical experience using Agile methodologies; exposure to Scaled Agile (SAFe) preferred.
• Experience working with health‑plan operations and IT.
• Experience as a project manager in a healthcare setting.
• Experience with adult learning and development.
• Exposure to claims, provider payment, provider onboarding, or contracting operations within a healthcare payer environment.

Equal Opportunity Employment

HF Management Services, LLC complies with all applicable laws and regulations. Applicants and employees are considered for positions and are evaluated without regard to race, color, creed, religion, sex, national origin, sexual orientation, pregnancy, age, disability, genetic information, domestic violence victim status, gender and/or gender identity or expression, military status, veteran status, citizenship or immigration status, height and weight, familial status, marital status, or unemployment status, as well as any other legally protected basis. HF Management Services, LLC shall not discriminate against any disabled employee or applicant in regard to any position for which the employee or applicant is otherwise qualified.