Jobs at Healthfirst - Page 2

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Displaying results 16 - 30 of 94

CPM Analyst

Healthfirst - New York, NY

Responsibilities: Duties and Responsibilities: Works with other CPM staff to contribute to core departmental activities Compiles information from multiple sources to generate timely, organized and accurate reporting for internal and external audiences Preparesand distributes recurring reports Uses Business Intelligence tools...

Application Deadline: None

Administrative Assistant

Healthfirst - New York, NY

Responsibilities: Duties and Responsibilities: Being responsible for varied administrative duties within the Medical Management department. Composing Typing correspondence, relaying confidential information, gathering and interpreting information to develop reports and maintain departmental files, assisting in monitoring departmental budgets, scr...

Application Deadline: None

Non-Clinical Coordinator, Appeals and Grievances (Telecommuter)

Healthfirst - Ny, 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 Quality Improvement Department. Requests waivers from providers for non-clinical Medicar...

Application Deadline: None

Provider Auditor

Healthfirst - New York, NY

Responsibilities: Audit of provider record entries and data. Audit and handles specific entry and modification requests for weekly requirements. Identify defects and improve departmental performance by supporting quality, operational efficiency and production goals. Solicit and coordinate required information between Management staff and team members t...

Application Deadline: None

Supervisor Utilization Management

Healthfirst - Telecommuter

Responsibilities: Oversees the provision of Utilization Management functions which include: Pre-Certification, Concurrent Review, as well as Discharge Planning for Admissions and Outpatient Services. Continuously evaluates work-flow issues while seeking to improve processes that impact the Department. Supervises, analyzes and coordinates the daily activities of the unit to ...

Application Deadline: None

Healthcare Analyst

Healthfirst - New York, NY

Responsibilities: Monitorand understand costs and revenue trends for Provider Organizations. Responsiblefor creating, modifying and updating financial reports and analysis for Provider Organizations. Documentall coding, methodology and assumptions, data issues and report resultsfor each analysis. Prepareperiodic financial performance review presentatio...

Application Deadline: None

Programmer Analyst, Pharmacy

Healthfirst - New York, NY

Responsibilities: Analyzes data and creates reporting from appropriate systems. Designs complex algorithms/programs to mine through data within Healthfirst's Enterprise 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 t...

Application Deadline: None

Senior PHSP Enrollment Specialist

Healthfirst - New York, NY

Responsibilities: Retrieve NYS membership files provided in an excel format and accurately data enter records into Healthfirst's membership system. Reconcile NYS membership files with the appropriate Health plan membership system to ensure membership details are accurately entered. Provide a reconciled report on a monthly basis. Respond to all Member Services Mem...

Application Deadline: None

Assistant Vice President (AVP) Hospital Relations

Healthfirst - New York, NY

Responsibilities: Accountable leader for hospital network development and management through customer focused leadership and team development. Collaborate with vice president of network management and with senior leaders to represent the department, propose solutions and make decisions in the best interests of the department and Healthfirst's overall as it relates to corpor...

Application Deadline: None

Senior QA Automation Engineer IT Quality Assurance

Healthfirst - New York, NY

Responsibilities: Design, develop, implement and maintain a cost effective, long-term automation strategy and framework to increase regression testing accuracy, coverage and reduce regression timelines Enhance HF Test Automation Framework using advanced techniques such as hybrid, key-word, and data driven methodologies Review functional specifications an...

Application Deadline: None

Manager, Compliance and Regulatory Oversight

Healthfirst - New York, NY

Responsibilities: Duties Responsibilities: Regulatory Regulatory surveillance Monitor Centers for Medicare and Medicaid Services (CMS), NY State Department of Health Services (DOH) for new Pharmacy related requirements as they pertain to Medicare Medicaid. Advise the Pharmacy team of new regulations as they eme...

Application Deadline: None

Customer Service Representative - Bilingual Spanish

Healthfirst - Lake Mary, FL

Responsibilities: Interacts with customers to provide information in response to inquiries about products and services. Transfer customer calls to appropriate departments. Identify, research, and resolve customer issues using the computer system. Follow-up on customer inquiries not immediately resolved. Researc...

Application Deadline: None

Customer Service Representative

Healthfirst - Lake Mary, FL

Responsibilities: Interacts with customers to provide information in response to inquiries about products and services. Transfer customer calls to appropriate departments. Identify, research, and resolve customer issues using the computer system. Follow-up on customer inquiries not immediately resolved. Researc...

Application Deadline: None

ETL Developer

Healthfirst - Lake Mary, FL

Responsibilities: Understand business requirements and translate them to technical specifications. Develop SAS and 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 inform...

Application Deadline: None

Service Coordinator - Spanish

Healthfirst - Telecommuter

Responsibilities: Scheduling member non emergent medical transportation. Bilingual Spanish and English. Provide feedback regarding transportation services to Service Coordinator Supervisor. Handle incoming telephone calls and answer questions for callers to support the efficient operation of the Care Management Team. Provid...

Application Deadline: None