Implementation Lead

Alaffia Health•,

1d•Remote

About The Position

Alaffia is a new kind of claims operations partner for health plans, using expert clinicians and transparent AI to deliver deeper insights, smarter automation, and consistently better outcomes across the entire lifecycle of claims. This role is for a high-growth, venture-backed Series B healthtech startup based in NYC. As the Implementation Lead, you will own end-to-end delivery for new Payment Integrity clients, ensuring a seamless transition to Customer Success and Account Management. This is a technical, domain-driven role suited to someone fluent in claims data and payment integrity workflows who can engage credibly with a client's technical and clinical stakeholders. As a foundational hire for this function, you will also help establish the implementation methodology and best practices that will scale with Alaffia's growth.

Requirements

5+ years of experience in healthcare technology implementation, payment integrity, or claims auditing — payer, provider, or vendor side
Strong working knowledge of claims and payment integrity concepts: DRG validation, UB-04/itemized bill review, CPT/ICD-10/HCPCS, medical necessity, FWA
Experience configuring or implementing SaaS platforms for healthcare or health plan clients (claims platforms, payment integrity or utilization management tools, payer systems)
Demonstrated ability to build client trust and credibility through technical expertise and reliable execution
Self-directed, with the ability to help define process and best practices within a growing function

Nice To Haves

Familiarity with payment integrity vendors such as Cotiviti, HMS/Gainwell, or Equian/Zelis is a plus
PMP, Lean Six Sigma, or similar project methodology experience is a plus but not required

Responsibilities

Own the implementation lifecycle: Manage the handoff from Solutions, scope technical requirements with the client, configure the platform, and integrate client data feeds through go-live.
Work directly with claims data: Configure and validate payment integrity logic against claims data (UB-04/itemized bills, ICD-10, CPT/HCPCS, DRG), and troubleshoot data or configuration issues.
Serve as the client's technical point of contact during implementation: Translate technical and clinical requirements clearly, gather specifications, and provide consistent client communication throughout the engagement.
Coordinate cross-functionally: Partner closely with Engineering, Product, and Claims/Clinical teams to resolve issues and keep implementations on track.
Manage the project plan and risk: Build timelines, proactively identify risks, and drive issues to resolution.
Ensure clean handoff to Customer Success: Document implementation context and client requirements to support a smooth transition post go-live.
Contribute to process design: Help establish the implementation methodology, templates, and standard configurations that will support Alaffia's growth.