Most Recent Healthfirst Job Listings (Page 5)

Displaying results 61 - 75 of 95
Healthfirst

Senior QA Automation Analyst

Healthfirst - New York, NY
Responsibilities: Participate in designing , developing, implementing and maintaining a cost effective, long-term testing strategy and framework promoting reusable components, low maintenance costs, high efficiency and scalability. Facilitate in the integration opportunities for the manual and automated test tools. Effectively employ effective test to reduce testing cycles ...
Application Deadline: None
Healthfirst

Assistant Director, Physician Relations

Healthfirst - New York, NY
Responsibilities: Responsible for the daily operational processes within the Physician Relations department which include reviewing and revising said processes. Identifies areas of improvement and works with internal departments to streamline processes. Trains, coaches and mentors staff based on these processes, manages performance, and identifies areas of improvement for further trai...
Application Deadline: None
Healthfirst

Associate General Counsel

Healthfirst - New York, NY
Responsibilities: Maintains familiarity with all requirements of law and regulation affecting the operation of a managed care company. Provides legal support to business and strategic initiatives of the company and answers inquiries from staff regarding legal issues. Advises General Counsel and other managers regarding legal, regulatory and business options avail...
Application Deadline: None
Healthfirst

Manager, Behavioral Health Care/Utilization Mgmt. (HARP)

Healthfirst - Telecommuter
Responsibilities: Managelarge group ofemployees in the Behavioral Health HARP (Health and Recovery Plan) Utilization (UM) and Care (CM) Management Teams. Monitor the volume and quality of work, evaluate staffing, operational needs and ensure availability of appropriate resources to meet business requirements. Ensure that staff work in collaboration with all members of the care team (i...
Application Deadline: None
Healthfirst

Behavioral Health Care Manager/UM HARP

Healthfirst - Telecommuter
Responsibilities: Performs clinical review including pre-certification, concurrent and retroactive review , of all requests for behavioral health treatments and rehabilitative and recovery oriented services for assigned case load of members enrolled in Healthfirst's Health and Recovery Plan. Issues notification of determinations and appeal rights. Manages work in accordance with d...
Application Deadline: None
Healthfirst

Senior Finance Operations Analyst

Healthfirst - New York, NY
Responsibilities: Perform monthly vendor reconciliations to insure all data received from vendor is aligned with payments. Creating monthly vendor reporting, operations calendars and statistical reporting relevant to claims payables. Process and file monthly state payments for surcharge. Prepare monthly calculation for retained payments and associated ...
Application Deadline: None
Healthfirst

Reassessment Nurse - Custodial Care UAS Assessor

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
Healthfirst

Senior QA Analyst

Healthfirst - New York, NY
Responsibilities: Ensure all strategic projects and operational projects meet the highest quality possible by following industry recognized QA methodologies and best practices. The candidate must have experience in structured testing methodology, with a proven ability to breakdown business requirements/functional/non-functional requirements into high and detailed test cases and test s...
Application Deadline: None
Healthfirst

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
Healthfirst

Manager, Analysis (Encounter Reporting)

Healthfirst - New York, NY
Responsibilities: Lead a team of analysts in supporting the production of encounters and submission of encounter files to agencies as required. Responsibilities include reviewing encounter data for quality and accuracy. Oversee the handling of both internal and external errors in encounter process. Internal errors are encounter records that fail pre-processing validation an...
Application Deadline: None
Healthfirst

Facilities Support Specialist I

Healthfirst - New York, NY
Responsibilities: Perform building maintenance, including minor repairs of office furniture, replacement of ceiling tiles and, troubleshooting A/C electrical shorts and flushing out A/C drainage systems. Replace light bulbs, maintain the proper operation of light fixtures repair, replace door locks, complete daily work order and repairs. May coordinate vendors providing sai...
Application Deadline: None
Healthfirst

Director, Business Operations

Healthfirst - New York, NY
Responsibilities: Directs and coordinates activities related to network management in concert with Network Management staff, including but not limited to policy development, contract and reimbursement strategy and fee negotiation, quality improvement, products and benefits, provider recruitment and relationship development, new provider orientation and education, retention of cont...
Application Deadline: None
Healthfirst

Supervisor - Server Group

Healthfirst - New York, NY
Responsibilities: Development and management of engineers ensuring that the team is operating and functioning as efficiently as possible and with the required knowledge needed for operations and maintenance of systems, acquisition installation of enterprise hardware software, resource planning an project management. Utilizes oral and written business communication skills to...
Application Deadline: None
Healthfirst

Supervisor Utilization Management

Healthfirst - Telecommuter
Responsibilities: Oversees the provision of Utilization Management functions which include: Pre-Certification, Concurrent Review, as well as Discharge Planning for Admissions and Outpatient Services. Continuously evaluates workflow issues while seeking to improve processes that impact the Department. Supervises, analyzes and coordinates the daily activities of the unit to e...
Application Deadline: None
Healthfirst

Behavioral Health Care Manager - Utilization Review

Healthfirst - Telecommuter
Responsibilities: Performs initial, concurrent, and discharge reviews for members being treated in facilities. Evaluates and pre-authorizes requests for mental health services in community based settings to ensure timely access to the most appropriate, least restrictive, level of care in accordance with department and regulatory guidelines. Collaborates with members of the ...
Application Deadline: None
Displaying results 61 - 75 of 95