Jobs at Healthfirst - Page 4

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Displaying results 46 - 60 of 98

Manager, Analysis (Data Governance)

Healthfirst - New York, NY

Responsibilities: Manages the day-to-day project schedule for EIM (Enterprise Information Management) program Manages the interdependencies with other projects that have an impact to or a dependency on the EIM program Contributes to the Data Governance portal. Attend the Data Governance Council and Steering Committee agenda and materials Support the Data Governanc...

Application Deadline: None

Senior Healthcare Analyst

Healthfirst - New York, NY

Responsibilities: Utilize research methods to analyze various data sets. Provide analysis support for Claims, Ancillary, Medical Management, etc. departments. Support analysis projects related to medical cost savings initiatives. Assist with project management responsibilities related to the medical cost savings meetings. Assist in drill down analyses to identify...

Application Deadline: None

Senior Healthcare Analyst - Hospital Reporting

Healthfirst - New York, NY

Responsibilities: Produce and manage annual hospital performance review packets. The packets will include membership, revenue, and cost analysis for the hospital and overall Healthfirst. The person will be required to work with other departments to gather all relevant information on the hospital's performance. Monitor costs and revenue trends for hospitals and identify rout...

Application Deadline: None

Nurse Care Manager - SHP

Healthfirst - Telecommuter

Responsibilities: Maintains ongoing telephonic communication with members and their caregivers to ensure a safe and appropriate care plan. Member family education re: health management and community resources. Appropriately manages member care including but not limited to; coordination of benefits (Medicare Medicaid), coordinating monitoring all skilled services,...

Application Deadline: None

Learning Technologies Specialist

Healthfirst - New York, NY

Responsibilities: Design, develop, and implement innovative learning solutions in the form of webinars, custom e-learning courses, blended learning solutions, videos, games, simulations, quizzes, online communities, message boards, websites, etc. Facilitate instructor-led live and virtual programs. Manage the current LMS (or use your expertise to identify a new o...

Application Deadline: None

VP Pharmacy

Healthfirst - New York, NY

Responsibilities: Duties Responsibilities: Overseeing pharmacy benefits Monitoring regulations and program changes Ensuring timely implementation by CMS guidelines Managing the STAR (Medicare) activities relative to pharmacy Overseeing adherence, Member education, oversight of other external Vendors (Medication th...

Application Deadline: None

Service Delivery Manager

Healthfirst - New York, NY

Responsibilities: Ensure Service Desk delivery targets are met and appropriate quantitative standards are achieved. Drive performance against the Service Level Agreements (SLAs) and Key Performance Indicators (KPIs) Handle large volume population of IS requests with regards to all business units Develops and implements robust processes to ensure that h...

Application Deadline: None

Member Services Supervisor

Healthfirst - Lake Mary, FL

Responsibilities: Supervising the day-to-day activities of member service representatives who responds to member inquiries to ensure effective delivery of service to members and providers. Tracking performance production stats fortheirdirect reports team. Review daily reports and identify trends to provide coaching or action plans with team and or departments. ...

Application Deadline: None

Clinical Performance Management Analyst

Healthfirst - New York, NY

Responsibilities: Under the supervision of a CPM Manager, the CPM Analyst uses data extraction, transformation, analytic and presentation skills, including Microsoft Excel, Word, PowerPoint, SAS, SQL, or other software tools to prepare and present analyses related to healthcare services utilization, enrollment or other data pertinent to requests from business customers. Busin...

Application Deadline: None

Technical Writer

Healthfirst - New York, NY

Responsibilities: Creates and maintains SDLC Templates used for change requests, specifications, Technical Design Documents Creates and maintains Policy and Procedure Manuals and related Job Aid documents Captures and Documents Disaster Recovery procedures for mission critical business systems Ensures that documents follow the style laid out i...

Application Deadline: None

VP of Compliance and Audit, Chief Compliance Officer

Healthfirst - New York, NY

Responsibilities: Implement and maintain a compliance program that meets the expectations of State and Federal regulators. Collaborate with other Healthfirst departments and the Corporate Risk Management and Compliance Committee to ensure the effectiveness of Healthfirsts compliance efforts. Identify areas of compliance risk for Healthfirst. Ensure int...

Application Deadline: None

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

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

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