Most Recent Healthfirst Job Listings

Displaying results 1 - 15 of 107
Healthfirst

Interactive Workforce Analyst (Call Center)

Healthfirst - New York, NY
Responsibilities: Real Time Management Activities Identify and coordinate real-time phone/non-phone activities such as overtime, meetings, training, and special projects. Plan all training, project time, and off-phone activities, and special events and input into Workfoce Management (WFM) tool (or Excel Application) to ensure an accurate view of staffing availability. Coordinate w...
Application Deadline: None
Healthfirst

Managed Service Organization (MSO) Account Representative

Healthfirst - New York, NY
Responsibilities: Review and maintain MSO requests ensuring quality standards and expectations are met. This includes, but is not limited to, responsibilities for MSO communication, conflict resolution and compliance. This will be managed by the MSO Manager through weekly and monthly planning meetings with expectation of collaboratively achieving structure and consistent communication inter...
Application Deadline: None
Healthfirst

Enrollment Medicaid Supervisor, Mandarin/Cantonese

Healthfirst - New York, NY
Responsibilities: Supervise Enrollment Medicaid Specialists. This includes: observing staff in the field and conducting customer phone surveys to ensure all Enrollment and Medicaid applications are completed in accordance with Company protocols and State regulations. Ensure staff understand the care management model, can support enrollment growth and are able to answer routine questio...
Application Deadline: None
Healthfirst

Enrollment Medicaid Specialist Liaison

Healthfirst - New York, NY
Responsibilities: Conducts daily screening of eligibilities. Monitors applications submitted for deadlines. Monitors applications due to the LDSS for faster and more accurate enrollment. Conducts pre-screening for financial eligibility. Prepares appropriate paperwork for individuals. Enters timely and accurate client data into Electronic Medical Record (EMR proprietary database system...
Application Deadline: None
Healthfirst

Pharmacy Data Analyst

Healthfirst - New York, NY
Responsibilities: Analyzes data and creates reporting from appropriate systems. Designs complex algorithms/programs to mine through data within Healthfirst'sEnterprise Data Warehouse (EDW) and ad-hoc data sets. Seeks out and adopts best practices in data reporting. Documents policies and procedures; handles reporting, project specifications, job aids and workflows within th...
Application Deadline: None
Healthfirst

Regulatory Complaint Analyst

Healthfirst - New York, NY
Responsibilities: Records all provider and member complaints and inquires initiated by local, state and federal regulatory agencies as well as governmental contracted entities into a company workflow management system. Identifies the root causes of complaints and works with the applicable operational departments to implement an appropriate resolution such as Finance, Enroll...
Application Deadline: None
Healthfirst

Asstant Director, Product Marketing

Healthfirst - New York, NY
Responsibilities: Leverages consumer insights and past experience with commercial, Medicare, and/or Medicaid health insurance plans to develop and drive product marketing strategies encompassing multi-channel acquisition, engagement, and retention initiatives. In collaboration with internal partners, (i.e.: product management, member services, sales teams, etc.) builds integrated mark...
Application Deadline: None
Healthfirst

Health Care Claims Analyst (Benefits Design Analyst)

Healthfirst - New York, NY
Responsibilities: Benefits Design Analysis: Assist in the on-going evaluation of benefits configuration for new and existing benefit plans within PowerMHS. Analyze explanation of coverage documents to assist with determining best approach for loading benefits offered including member cost share and out-of-pocket maximums. Assist in the setup of co...
Application Deadline: None
Healthfirst

Business Analyst (Provider Data/Network Analyst)

Healthfirst - New York, NY
Responsibilities: Analysis, Reporting and Performance Improvement: Analyze provider data processes and present findings. Work cross-functionally to recommend and request modifications to existing system processes addressing deficiencies and/or further improving and streamlining performance. Review technical specifications to ensure Dep...
Application Deadline: None
Healthfirst

Manager Community Outreach

Healthfirst - New York, NY
Responsibilities: Direct the Site Development unit to work in conjunction with the Medicare sales teams and the Regulatory and Marketing departments to develop relationships with community partners to create marketing opportunities, as well as, open sites for the Medicare sales representative to make education and sales presentations to seniors and others who may qualify for Medicare....
Application Deadline: None
Healthfirst

Appeals & Grievance Non Clinical Coordinator

Healthfirst - Telecommuter
Responsibilities: Ensures appeals and grievances are categorized and processed within New York State and Federal time frames. Enters all appeals and grievances in the Units software tracking system. Identifies potential quality issues and initiates referrals to the Appeals Grievances Clinical Team. Requests waivers from providers for non-clinical Medic...
Application Deadline: None
Healthfirst

Relationship Coordinator, Sales - Spanish

Healthfirst - New York, NY
Responsibilities: Calls prospective SHP clients according to approved scripts within 24 hours. Searches ePACEs for Medicaid eligibility, exclusion and exemption codes. Documents all client calls and outcomes in pre-enrollment database system. Achieves daily, weekly and monthly goals for outbound telemarketing calls and booking appointments. ...
Application Deadline: None
Healthfirst

Support Coordinator - Complete Care

Healthfirst - Telecommuter
Responsibilities: Communicate with service providers regarding authorizations including, but not limited to, outreach calls and mailings to members and providers, telephonic calls to community-based organizations, calling providers with the pre-certification number, entering cases in CCMS (CareEnhance Clinical Management Software), education material mailings, benefit questions and is...
Application Deadline: None
Healthfirst

Ancillary Services Contractor

Healthfirst - New York, NY
Responsibilities: Recruit, contract and manage a network of Ancillary Providers for all lines of Healthfirst's business (such as Medicaid, Child Health Plus, Medicare, and Commercial). Monitor and audit contracted ancillary providers to ensure that accurate demographic, payment and fee schedules are loaded into the Healthfirst Provider System correctly. Resolve c...
Application Deadline: None
Healthfirst

Provider Outreach Specialist

Healthfirst - Lake Mary, FL
Responsibilities: Make outbound calls to Healthfirst network providers to validate member access to services and existing demographic information currently contained in the Healthfirst Provider Database in accordance with Access and Availability surveys and Provider Spot checks. Record responses and initiate database updates accordingly. Compile survey results for distribution to Netw...
Application Deadline: None
Displaying results 1 - 15 of 107