Jobs at Healthfirst - Page 3

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Displaying results 31 - 45 of 108

Education Manager, Medical Management

Healthfirst - Telecommuter

Responsibilities: Oversees the training of new hire staff related to the provision of the basic departmental functions which include: pre-certification, concurrent review, discharge planning, case management, disease management, appeals processing and referrals, Healthfirst and SHP standards and the rules/regulations set forth by the Company, the Department of Health and state and fed...

Application Deadline: None

Program Manager

Healthfirst - New York, NY

Responsibilities: Planning, directing and coordinating project activities through the entire project life cycle (from initiation to close). This includes setting clear project milestones and deliverables, communicating goals, objectives and responsibilities, keeping the project focused in terms of scope, schedule, communication and risk. Creating and executing project plans...

Application Deadline: None

Information Analyst

Healthfirst - Telecommuter

Responsibilities: Supports the implementation of structures and processes to ensure the successful and timely delivery of regulatory and contractual data requirements for State of New York (DOH) and Medicare(CMS). Develops, maintains and communicates time lines to meet assigned project goals using adopted project standards. Provides prospective, concurrent and re...

Application Deadline: None

Healthcare Translator - Bilingual Spanish

Healthfirst - New York, NY

Responsibilities: Support the Healthfirst staff by interpreting the staff-to-member and member-to-staff conversation. Facilitate cross-cultural communication within allotted time for staff member and client. Provide care management support to members and their family. Respond to member questions and resolve minor problems as directed. Remain accessible...

Application Deadline: None

Business Analyst, Network Management

Healthfirst - New York, NY

Responsibilities: Effectively manages projects by setting clear project milestones and deliverables, clearly communicating goals, objectives and responsibilities, keeping the project focused in terms of scope and deliverables and meeting project time-lines. Leads or participates in meetings to gather and specify departmental requirements for such projects Compiles, verifies...

Application Deadline: None

Care Management Program Coordinator

Healthfirst - New York, NY

Responsibilities: In collaboration with the VP of Care Management manages and supports care management initiatives relative to population health and engagement. Acts as the CM liaison for all care management initiatives both internal and external and attends meetings as required by VP Maintains well-documented master work plan to monitor activities, progress and ...

Application Deadline: None

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

Social Worker -SHP

Healthfirst - Telecommuter

Responsibilities: Uses all available resources to assess members' psychosocial health status and social work needs; this includes making field home visits as needed in order to complete a psychosocial assessment for all new members within the first 30 days of enrollment. Determines member and family needs to develop a comprehensive care plan for each member based on counsel...

Application Deadline: None

Delegated Vendor Specialist

Healthfirst - New York, NY

Responsibilities: Monitor delegated vendor and internal business owner relationships to ensure compliance, optimal delegate performance and achievement of business goals according to Service Level Standards and other contractual requirements. Maintain highly effective working relationships with delegated vendors and internal business stakeholders to ensure performance metri...

Application Deadline: None

Quality Improvement Representative

Healthfirst - Lake Mary, FL

Responsibilities: Evaluates Provider Services calls in accordance with departmental quality standards. Reviews findings with representatives and provides coaching and feedback as needed. Communicates observations and results of scores to team supervisors and QI management. Identifies trends, conducts root cause analysis, and makes recommendations for improvement ...

Application Deadline: None

Junior Web Developer

Healthfirst - New York, NY

Responsibilities: Assists in making layout and site changes withinthe development environment Delivers daily and weekly updates to the Healthfirst corporate website as well as any marketing microsites or internal applications Slices Adobe Photoshop (PSD) files for development of corporate and marketing websites/microsites Converts Adobe Photoshop files...

Application Deadline: None

Sr. Biztalk Developer

Healthfirst - Lake Mary, FL

Responsibilities: Responsible for working with Project Manager, Architect and lead the design, development and implementation of EAI framework, infrastructure components and application integration solutions based on the requirements and the overall technical architecture. Design and develop integration solutions using service oriented architecture (SOA) based, industry sta...

Application Deadline: None

Healthcare Analyst - Hospital Reporting

Healthfirst - New York, NY

Responsibilities: Provide support to the Provider Organizations performance improvement work groups. Monitor costs and revenue trends for Provider Organizations and assist in understanding trends. Understand and analyze impacts of new program changes. Responsible for creating, modifying, and updating analysis for Provider Organizations. Resp...

Application Deadline: None

Network Management Representative

Healthfirst - New York, NY

Responsibilities: Developing Maintaining positive relationships with physicians, providers, and practice managers within the provider network Providing high quality service to physicians, providers, and practice managers Ensuring Providers' issues and needs are responded to in a timely and accurate fashion. Ability to review a Provider issue, identify root cause,...

Application Deadline: None

Informatics Nurse

Healthfirst - New York, NY

Responsibilities: Provides prospective, concurrent and retrospective analysis utilizing the most current data sets available to identify and support improvement activities designed to enhance clinical programs within Healthfirst's Medical Management/Appeals and Grievances Departments. Works closely with the Informatics team to identify and monitor the quality of data imported and util...

Application Deadline: None