Jobs at Healthfirst - Page 4

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Displaying results 46 - 60 of 99

Business Analyst

Healthfirst - Lake Mary, FL

Responsibilities: PositionSummary: The Business Analyst will be responsible for all Member Services business systems and analysis as it relates to enhancements to existingMember Servicesnew product lines and/or clients. Act as the liaison between own business unit and IS/Third Party team. Work closely with Project Managers, IS, Product...

Application Deadline: None

Reinsurance Reconciliation Analyst

Healthfirst - New York, NY

Responsibilities: Compile data related to claims to determine reinsurance eligibility. Review previously billed and denied data to correcterrors and rebill to maximize collections. Apply cash to outstanding receivables when applicable. Work with claims to determine eligibility, incorrectprocessing and correction strategy....

Application Deadline: None

Director, Population Health Outreach Programs

Healthfirst - New York, NY

Responsibilities: Team Leadership Drives strategy for Spectrum of Health Program, HEDIS Analytics and Reward Card Program Sets team and individual goals aligned to organizational strategy and goals regarding engagement and quality Monitors group and individual performance/progress Evaluates progress and ada...

Application Deadline: None

Talent Acquisition Partner - Information Technology

Healthfirst - New York, NY

Responsibilities: Build relationships with hiring managers and HRBPs to understand current line of business needs and objectives. Define job descriptions, and develop and implement recruiting strategies that fit business needs and budget considerations through a deep understanding of return on investment. Identify and implement appropriate recruiting processes such as setti...

Application Deadline: None

Enrollment Medicaid Specialist, bilingual English & Mandarin/Cantonese

Healthfirst - New York, NY

Responsibilities: Conducts individual pre-enrollment screening: Meets with individuals who may qualify for enrollment in Senior Health Partners throughout the 5 boroughs, Westchester and Nassau County. Explains the program features, benefits and commitments, including explanation of the Member Handbook. Conducts pre-screening for financial elig...

Application Deadline: None

Scheduling Liaison - Cantonese

Healthfirst - New York, NY

Responsibilities: Review and organize CCMS (CareEnhance Clinical Management Software), Electronic Medical Records (EMR) pre-enrollment database system, schedule reports for field staff (Nurses and/or Enrollment 50+) to ensure daily goals for SHP, CC and PHSP are being achieved. Section the report by language needs and County for maximum efficiency in assigning active and pr...

Application Deadline: None

Healthcare Translator - Cantonese and Mandarin

Healthfirst - New York, NY

Responsibilities: Translation services: 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 families. Respond to member questions and resolve minor problems as directed. Remain accessibl...

Application Deadline: None

Provider Operations Supervisor

Healthfirst - Lake Mary, FL

Responsibilities: Ensuring team maintains or exceeds established team production standards and meeting deadlines set for all projects. Ensures timely performance measurement and assists in the identification and implementation of improvement initiatives. Conducting ongoing coaching to the Provider Operations Reps and Seniors.Respond to Provider Operations Represent...

Application Deadline: None

Manager, Actuarial Services

Healthfirst - New York, NY

Responsibilities: Monitoring performance on all lines of business and update forecasts as appropriate Compare actual monthly results to latest forecasts as well as budget Build and maintain Healthfirsts quarterly forecast models. Co-ordinate input from Product and Finance for each of our quarterly forecast process. Co-ordinate with Budget to...

Application Deadline: None

Reassessment Nurse-Bi-lingual Spanish

Healthfirst - New York, NY

Responsibilities: Conducts UAS (Uniform Assessment System) for active members 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/Caregiver to determine if service level(s) need to be adjusted. Completes Patient Review Instruments/Screens and all required n...

Application Deadline: None

Healthcare Translator - Bilingual Korean

Healthfirst - New York, NY

Responsibilities: Translation services: 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 families. Respond to member questions and resolve minor problems as directed. Remain accessibl...

Application Deadline: None

Driver, Community Outreach Vehicle

Healthfirst - New York, NY

Responsibilities: Maintains a clean and organized COV/cargo van on a daily basis. Checks the interior and exterior of the vehicle for cosmetic and operational concerns. For example, checking for loose cabinet handles, hanging wall paper, torn rugs/ floors, dents and cracks, broken glass and rest room malfunctions. Performs minor maintenance tasks on the vehicle when necessary, this wi...

Application Deadline: None

VP Network Management

Healthfirst - New York, NY

Responsibilities: The new Vice President, Network Management will focus on the following objectives during his/her first year: Establishing credibility with key stakeholders including the Healthfirst executive team, the provider community and the network management staff. Leading the network management team in its continuous expansion through increased provider c...

Application Deadline: None

Clinical Quality Assurance Auditor RN

Healthfirst - New York, NY

Responsibilities: Review clinical documentation in order to ensure that all components of the Member's medical record are completed with quality standards and accuracy following the Company's policies and State regulations. Assist the Clinical Educator, as needed, to determine areas that require immediate remediation andassist Healthfirst's employees to stay ah...

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