Jobs at Healthfirst - Page 5

99 job openings

Save This Search

Refine Your Search

Show more Show less
Displaying results 61 - 75 of 99

Manager Member Experience

Healthfirst - New York, NY

Responsibilities: Duties Responsibilities: Organize forums and committees for member feedback. This involves setting agendas using MS Word, creating PowerPoint presentations, engaging relevant internal and external stakeholders, working with Community Events department to organize events and manage logistics, ensuring that regulatory standards and organizat...

Application Deadline: None

Specialist, Medical Management Regulatory

Healthfirst - New York, NY

Responsibilities: Meets with Regulatory to organize pre-survey deliverables and conduct 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 enti...

Application Deadline: None

Director, Business Development

Healthfirst - New York, NY

Responsibilities: Participates in developing, prospecting and recruiting potential M A and joint venture targets, including in-person meetings, information gathering sessions and negotiating sessions Collaborates with cross functional teams as well as external consultants to conduct market research, perform evaluations, identify specific business launch approaches (organic ...

Application Deadline: None

Business Analyst Manager

Healthfirst - Lake Mary, FL

Responsibilities: Managing the teams progress on various daily report requests, projects, and testing to ensure quality and deadlines are met. Monitoring Business Analysts activities to ensure quality control and work is met, as well as coach, develop and conduct performance evaluations for each individual. Leading organizational and departmental reporting develo...

Application Deadline: None

Writer/Editor, Correspondence Unit

Healthfirst - New York, NY

Responsibilities: Performs daily reviews of manual letters produced from CCMS to member and providers to ensure adherence to Article 44 and 49 of the NY State Public Health Law and Appendix F, Medicare Managed Care Manual Chapter 13 and commercial contracts and others as necessary. Ensure compliance to Healthfirst corporate branding requirements. Conducts quality...

Application Deadline: None

Nurse Care Manager Welcome Team

Healthfirst - New York, NY

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

Senior Manager, Pharmacy Quality

Healthfirst - New York, NY

Responsibilities: Duties and Responsibilities: Identifies, implements and leads initiatives to drive pharmacy quality performance measures related to STARS and HEDIS measures as set forth by Federal and State regulatory agencies. Serves as the Subject Matter Expert (SME) within Healthfirst for Pharmacy-related quality measures. ...

Application Deadline: None

HR Concierge

Healthfirst - New York, NY

Responsibilities: Employee Assistance serve as a primary interface and first line resource for employee questions, inquiries, walk-ins or general information on many topics regarding the employee life cycle. Assist employees through triage, research, resolution, education or redirect to appropriate Healthfirst areas. Some areas of focus include, but not limited to:

Application Deadline: None

Educator Clinical RN

Healthfirst - New York, NY

Responsibilities: Duties and Responsibilities: Successful candidate is the first source of job-related information and is required to train/teach about products, processes and policy information at the onset of the hiring process and on a continuous need basis to help current Healthfirst employees stay abreast of evolving information as well as improve the ...

Application Deadline: None

VP, Claims Operations

Healthfirst - New York, NY

Responsibilities: Strategic Business Management: In conjunction with Healthfirst and Operations leadership, establishes and communicates current and long range department goals and objectives and monitors results on a monthly basis, adjusting plans and performance expectations to achieve targeted results. Provides strategic guidance, direction and manag...

Application Deadline: None

Data Analyst (Finance)

Healthfirst - New York, NY

Responsibilities: Analyze and reconcile premium revenue and remittance status. Account for rate changes across all product lines. Support and report Accounts Receivable sub-ledger aging and collections. Create reports using SAS to assist in reconciliations and assist the team to create data driven processes that improve efficiency of monthly close processes. Collect and ana...

Application Deadline: None

Account Receivable Analyst (Finance)

Healthfirst - New York, NY

Responsibilities: Generate and review State billing file for all Healthfirst products. Ensure billed records are accurate based on approved contracted rates from Department of Health. Correct any errors from exception reports. Identify and bill Kick events (Maternity, Newborn and Low Birth Events). Maintain the infrastructure of Paid Claim support files used to support bill...

Application Deadline: None

Behavioral Health Representative, Ancillary Dept.

Healthfirst - New York, NY

Responsibilities: Assist in the development and recruitment of BH network providers based on department needs to support (HARP) requirements based on the anticipated needs of special populations, including, but not limited to: Transition age youth with BH needs; Adults and transition age youth identified with First Episode Psychosis (FEP); Individuals with Intellectual and Development...

Application Deadline: None

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 - 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