Most Recent Healthfirst Job Listings (Page 5)

Displaying results 61 - 75 of 99
Healthfirst

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
Healthfirst

Director Actuary, Medicare

Healthfirst - New York, NY
Responsibilities: Responsible for Medicare pricing, bids analysis and submission for both Part C and D as well as all desk reviews, actuarial audits associated with it. Responsible for monitoring the financial performance for our Medicare product lines. Monitor developing trends and participate in the monthly valuation for this product line. Responsible for the m...
Application Deadline: None
Healthfirst

Actuarial Analyst

Healthfirst - New York, NY
Responsibilities: Handle premiums, claims, enrollment, and administrative expense data for reports to government and regulatory entities (such as CMS, NYSID, NYDOH, etc.) and routine internal reports. Work on data incorporated into high level corporate reporting and monitor experience of all lines of business. Provide other data analysis as required by management...
Application Deadline: None
Healthfirst

Senior Manager, Clinical Analysis

Healthfirst - New York, NY
Responsibilities: Manages staff of Clinical Performance Management (CPM) Clinical Analysts to ensure timeliness, quality and efficiency of deliverables. Responsible for on-time delivery of internal reports to internal stakeholders, doctor groups and Provider organizations, and Regulatory agencies which are related to clinical performance and health services utilization of members and ...
Application Deadline: None
Healthfirst

Senior Application Support Analyst

Healthfirst - New York, NY
Responsibilities: Provide advanced level client support for the enterprise business units by interpreting responding to user needs. At times extended support hours are required outside of a normal work day. These instances are rare however they do occur and the Sr. Business Analyst is responsible for maintaining and restoring their applications to Production Ready levels. I...
Application Deadline: None
Healthfirst

Director, Hospital Relations

Healthfirst - New York, NY
Responsibilities: Serve as key liaison for all hospital-affiliated Providers. Oversee all aspects of hospital relationship management with staff to ensure a high performance hospital network. Ensure team has a strong focus on engagement with hospital network and deliver superior customer service which include but is not limited to: timely responses and follow-up ...
Application Deadline: None
Healthfirst

Reassessment Nurse -Primarily Long Island, Nassau and Suffolk Counties

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/Scre...
Application Deadline: None
Healthfirst

Manager, Leadership Development

Healthfirst - New York, NY
Responsibilities: Collaborate to define the companys management and leadership development philosophy and strategy. Articulate, model and build consensus around a clear vision of leadership development with leaders at all levels. Bring innovative and creative leadership development solutions to bear on complex organizational development needs by leveraging progre...
Application Deadline: None
Healthfirst

Senior Manager, Compensation

Healthfirst - New York, NY
Responsibilities: Partner with HRBPs, Finance, HRIS and business leaders to develop, streamline, automate, and implement compensation policies, guidelines, and programs to establish corporate standards, as well as to meet varied market needs across all lines of business. Evaluate all programming for effectiveness based on annual strategic plan targets. Recruit, train,coach,...
Application Deadline: None
Healthfirst

Director, Enterprise Integration Services

Healthfirst - New York, NY
Responsibilities: Build and establish short and long term integration platform capabilities (people, process, technologies) across heterogeneous applications Plans, directs and coordinates activities in the selection, implementation, management and support of enterprise applications technology projects to ensure project goals are accomplished by performing duties personally...
Application Deadline: None
Healthfirst

Reassessment Nurse - Bronx, Manhattan

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/Scre...
Application Deadline: None
Healthfirst

Copywriter

Healthfirst - New York, NY
Responsibilities: Write and edit a wide range of promotional materials -- including letters, brochures, flyers, outdoor advertising, blog and website posts, email blasts, radio and TV scripts and other collateral -- that support effective member and provider communication and customer engagement. Candidate should be able to rapidly produce creative, professional, and persuasive materi...
Application Deadline: None
Healthfirst

Director Ancillary Contracting

Healthfirst - New York, NY
Responsibilities: Serve as the development and implementation lead on all projects related to Ancillary networks, including planning, execution, and monitoring performance of the network and staff. Key contact for regulatory, clinical and customer satisfaction initiatives related to ancillary networks, as well as oversee issue resolution as it relates to Claims, Medical Man...
Application Deadline: None
Healthfirst

Business Intelligence Solution Architect

Healthfirst - New York, NY
Responsibilities: Design, build and support the Enterprise Reporting solutions: Qlikview, Microsoft SSRS/SSIS, SAS, Crystal Reports. Architect data structures and processes to standardize, distribute and provide access to information across the organization. Lead the data architecture planning in support of enterprise data Reporting objectives. Provide t...
Application Deadline: None
Healthfirst

Claims Examiner

Healthfirst - New York, NY
Responsibilities: Review, investigate and adjudicate claims and encounters for medical services through contractual provisions in accordance with provider contracts and authorizations. Process new claim suspensions and reprocess (as needed) for discrepancies; as well as review other documentation for edits and consistency. All errors must be documented according to Healthfi...
Application Deadline: None
Displaying results 61 - 75 of 99