Most Recent Healthfirst Job Listings

Displaying results 1 - 15 of 97
Healthfirst

Associate Director, Learning and Development - Head of the Center for Employee Excellence

Healthfirst - New York, NY
Responsibilities: Manage team of professionals responsible for design, program management and implementation of mandatory and elective programs to drive the business strategy and culture. Responsible for the overhaul of Healthfirst University programs, to link directly to business goals and culture drivers, and strategize new creation of programs that meet focused needs and...
Application Deadline: None
Healthfirst

Performance Improvement Specialist

Healthfirst - Lake Mary, FL
Responsibilities: Completing performance improvement projects to meet deadlines and expected goals/ deliverables (i.e. facilitating team meetings, completing root cause analyses, compiling improvement opportunities, presenting project findings to the executive steering committee, as well as the project sponsors/owners). Individual must have superior analytical, communi...
Application Deadline: None
Healthfirst

Field Member Services Representative

Healthfirst - New York, NY
Responsibilities: Assist all Healthfirst members with inquiries in regards to benefits, claim payments and Healthfirst policies and procedures. Perform Primary Care Physicians and address changes for members using computer application. Investigate as well as resolve member complaints and concerns. Forward all necessary issues to correct departments or send issue/concerns to...
Application Deadline: None
Healthfirst

Manager, Claims Analytics

Healthfirst - New York, NY
Responsibilities: Unit Management and Oversight Responsible for the performance and resource management as well as oversight of the Claims Business Analytics Unit while defining and coordinating departmental projects, scope and objectives. Identifies, assigns, coordinates and manages the work assignments for Business and Operation Analyt...
Application Deadline: None
Healthfirst

Manager, Claims Adjustment (Reprocessing, Correspondence, etc.)

Healthfirst - New York, NY
Responsibilities: Performance Management Responsible for performance and resource management of staff handling mail correspondence, special handling, web portal and Provider Services requests. This includes staff responsible for analyzing, identifying root cause, summarizing results and working with other departments/units to resolve/fix s...
Application Deadline: None
Healthfirst

Payroll Analyst

Healthfirst - New York, NY
Responsibilities: Payroll preparation including UltiPro maintenance, pay data entries, check calculations. Upload extra earnings/benefits (401K auto enrollment/transit)/time and attendance files into the UltiPro payroll system. Update the UltiPro system with manual checks/voids/ adjustments. Validate HR/Payroll entries. Calculate overtime/regular retroactive payments due to salary inc...
Application Deadline: None
Healthfirst

ETL Developer

Healthfirst - Lake Mary, FL
Responsibilities: Understand business requirements and translate them to technical specifications. Develop informatica mappings and workflows to meet the data migration, cleansing and integratipon needs, using Informatica Powercenter. Develop error handling, data cleansing and exception reporting processes. Modify and/or enhance existing informatica co...
Application Deadline: None
Healthfirst

Senior Analyst, Internal Controls

Healthfirst - New York, NY
Responsibilities: Participate in the identification and rationalization of key controls. Such activities may include: Reviewing existing documentation, including MS Word-based Process Narrative, and Excel-based Risk and Control Matrix (RCM). Reviewing prior-year testing to determine if some controls should be combined or eliminated. Discussing key...
Application Deadline: None
Healthfirst

Director Actuary, Medicare

Healthfirst - New York, NY
Responsibilities: Responsible for Medicare pricing, bids analysis and submission for both Part C and D as well as all desk reviews, actuarial audits associated with it. Responsible for monitoring the financial performance for our Medicare product lines. Monitor developing trends and participate in the monthly valuation for this product line. Responsible for the m...
Application Deadline: None
Healthfirst

Actuarial Analyst

Healthfirst - New York, NY
Responsibilities: Handle premiums, claims, enrollment, and administrative expense data for reports to government and regulatory entities (such as CMS, NYSID, NYDOH, etc.) and routine internal reports. Work on data incorporated into high level corporate reporting and monitor experience of all lines of business. Provide other data analysis as required by management...
Application Deadline: None
Healthfirst

Supervisor, Information Systems

Healthfirst - New York, NY
Responsibilities: Supervise the activities of the development team throughout the software development life cycle. Prioritize, plan, assign, and monitor work for the team using input from the development team, senior management, and business partners. Manage Projects. Maintain project status and related documentation. Facilitate project related activities, including plannin...
Application Deadline: None
Healthfirst

Senior Manager, Clinical Analysis

Healthfirst - New York, NY
Responsibilities: Manages staff of Clinical Performance Management (CPM) Clinical Analysts to ensure timeliness, quality and efficiency of deliverables. Responsible for on-time delivery of internal reports to internal stakeholders, doctor groups and Provider organizations, and Regulatory agencies which are related to clinical performance and health services utilization of members and ...
Application Deadline: None
Healthfirst

Senior Application Support Analyst

Healthfirst - New York, NY
Responsibilities: Provide advanced level client support for the enterprise business units by interpreting responding to user needs. At times extended support hours are required outside of a normal work day. These instances are rare however they do occur and the Sr. Business Analyst is responsible for maintaining and restoring their applications to Production Ready levels. I...
Application Deadline: None
Healthfirst

Director, Hospital Relations

Healthfirst - New York, NY
Responsibilities: Serve as key liaison for all hospital-affiliated Providers. Oversee all aspects of hospital relationship management with staff to ensure a high performance hospital network. Ensure team has a strong focus on engagement with hospital network and deliver superior customer service which include but is not limited to: timely responses and follow-up ...
Application Deadline: None
Healthfirst

RN or LPN Appeals and Grievance Clinical Specialist

Healthfirst - Telecommuter
Responsibilities: Ensure that appeals and grievances are classified as an appeal or a grievance regarding either a denial of service, denial of payment or a grievance about a provider. These appeals and grievances are processed within New York and New Jersey State and Federal regulatory time frames, which could be standard (long period time) or expedited (3 day turnaround). ...
Application Deadline: None
Displaying results 1 - 15 of 97