Jobs at Healthfirst - Page 4

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Performance Improvement Specialist

Healthfirst - New York,Us, NY

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). Developing and maintainingvarious required performance...

Application Deadline: None

Programmer Analyst

Healthfirst - New York, NY

Responsibilities: The Senior Programmer Analyst develops and translates designs and specifications into various systems following programming standards. Demonstrates a proficiency in at least one of Healthfirsts programming languages (i.e., SQL. Server Integration Services (SSIS) or TSQL) while facilitating the transition of programs from development into production. Partic...

Application Deadline: None

Applications Support Analyst

Healthfirst - New York, NY

Responsibilities: Duties Responsibilities: Should be able to gain application skills via online training or via other resources within the IT division to serve as SME. Monitor Help Desk queue for new tickets and resolve issues to completion. Seek guidance and directions from other Analysts. Make sure that help desk tickets are register...

Application Deadline: None

Information Security Architect

Healthfirst - New York, NY

Responsibilities: Plan, design and implement security solutions, tools, and monitoring systems. Review new systems designs and major modifications for security implications prior to implementation. Document, analyze,and report on IS business processes to recommend security enhancement and improvements. Develop an organizational risk assessment framework based on HIPAA, NIST...

Application Deadline: None

Healthcare Analyst

Healthfirst - New York, NY

Responsibilities: Create, maintain and optimize SAS programs to support Finance Analysis data process. Document all coding, methodology and assumptions, data issues and report results for each analysis. Utilize research methods to analyze various data sets to support material financial adjustments for all Healthfirst products. Gather data and conduct a...

Application Deadline: None

Director - Operations Internal Audit, QA and Dedicated Testing

Healthfirst - New York, NY

Responsibilities: 1. Strategic Planning: Build, manage and develop an internal operations audit, quality assurance and dedicated testing department to meet the diverse and dynamic needs of a growing, evolving organization. Oversee all internal operations audit, quality assurance processes and dedicated testing processes to ensu...

Application Deadline: None

Director Medical Management - Commercial Business

Healthfirst - Telecommuter

Responsibilities: Develop a staffing model, reporting structure and metrics in order to monitor and measure productivity and departmental performance. Maintain NCQA readiness, accreditation and ongoing compliance. Collaborate with Talent Acquisition on the hiring of approved positions, and execute new needs requests for the department in order to support the grow...

Application Deadline: None

Clinical Quality Assurance Manager

Healthfirst - New York, NY

Responsibilities: Participating in different aspects of personnel management to ensure appropriate staffing, orientation, support, discipline and timely performance appraisals Ensuring that probationary and annual performance appraisals are completed in an objective manner; that employees are encouraged to complete their self-evaluation and that appraisals are completed in ...

Application Deadline: None

Registered Nurse, Medical Management - Regulatory

Healthfirst - Telecommuter

Responsibilities: Meets with Regulatory to organize pre-survey deliverables and conducts pre-survey reviews of materials. Interacts with and represents the Medical Management department and external auditors. Responds to auditor requests and audits outcome results. Prepares and coordinates on-site and electronic audits conducted by external regulatory entities. Coordinates ...

Application Deadline: None

Reassessment Nurse - Manhattan

Healthfirst - New York, NY

Responsibilities: Conducts UAS (Uniform Assessment System) for active members located in facilities throughout the five boroughs, Long Island and Westcheser every six months to determine service needs and continued eligibility. Completes reassessment of service needs at the request of the Care Team, Member's Family or Caregiver to determine if service level(s) ...

Application Deadline: None

Business Analyst (Claims Reporting-Analytics)

Healthfirst - New York, NY

Responsibilities: Analysis, Reporting and Performance Improvement: Develop and maintain new and existing reporting tools, databases and processes. Analyze various types of data and processes in a versatile manner and present findings and recommendations in a professional manner. Query and manipulate data to root cause, trend, summarize findings an...

Application Deadline: None

Enrollment Ops Analyst Supervisor

Healthfirst - Lake Mary, FL

Responsibilities: Supervise unit of operations analysts to ensure that departmental productivity and quality goals are met and/or exceeded. Communicate expectations and manage employee performance. Identify and manage the process of developing accurate reporting based on regulatory, employer group and/or organizational requirements. Establishes key metrics to be used in eva...

Application Deadline: None

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

Manager, Operations Product Management

Healthfirst - New York, NY

Responsibilities: Ensure accurate and timely benefit setup for all lines of business by working with IS, Enterprise Operations, Ancillary teams, and other departments. Incumbent will work with technical team to develop business requirements and technical specifications. Drive member material execution by establishing process and maintaining oversight for distribution of mem...

Application Deadline: None

Assessment Nurse Manager

Healthfirst - New York, NY

Responsibilities: Manage departmental operations such as oversight of scheduling, clinical consultations and staffing. Supervise and monitor productivity and accountability of nursing staff including assessment visits and management of service plans and home care hours. A subject matter expert (SME) to field Assessment RNs (Registered Nurse) providing guidance, support, professional c...

Application Deadline: None