Teams at Healthfirst, Inc

Independently manage a caseload of non-clinical member and non-contracted provider appeals across Medicare, Medicaid, dual and commercial lines. Research issues, interpret regulations and internal policies, prepare and submit appeals, finalize resolution letters, meet regulatory timeframes, identify denial trends, and recommend process improvements while maintaining productivity and quality standards.

Lead design, development, testing, and delivery of Qlik-based dashboards, reports, and healthcare applications. Build data extracts, optimize Qlik apps, develop NPrinting reports, write specifications and code, use Agile tools, support deployments, and train/assist end users and QA.