Most Recent Healthfirst Job Listings

Displaying results 1 - 15 of 69
Healthfirst

Social Worker (MSW) bilingual Mandarin/Cantonese

Healthfirst - Telecommuter
The Social Worker at Senior Health Partners (SHP) a Managed Long-Term Care (MLTCP) reporting to the Clinical Manager advocates for enrolled members by sustaining their mental and social health. Working with a Care Management Team (CMT), which includes a Nurse Care Manager and Service Coordinator the care management services and plans are achieved telephonically administering assessments and...
Posted Apr 16, 2014   —   Application Deadline: None
Healthfirst

Provider Services Representative

Healthfirst - Lake Mary, FL
The Provider Services Representative's fields inbound calls from providers related to billing and claims. This position answers general questions, identifies the root cause of issues and provides a resolution in line with Healthfirst Policy and Procedures. The Provider Services Representative will also escalate issues requiring management intervention, and document all actions within Health...
Posted Apr 14, 2014   —   Application Deadline: None
Healthfirst

Provider Quality Manager

Healthfirst - New York, NY
The Provider Quality Managerrequires that the manager oversee the day-to-day operations of all incentive programs which fall under the Healthfirst Quality Incentive Program umbrella. This involves the planning, designing, executing, releasing, and supporting of each incentive program on an annual basis.This position has two direct reports. Responsibilities: Planning, designin...
Posted Apr 14, 2014   —   Application Deadline: None
Healthfirst

Health Care Claims - Benefits Design Analyst

Healthfirst - New York, NY
The Benefits Design Analyst is responsible for assisting in the evaluation, design, testing, and implementation of required health plan benefits and payment structure changes. The incumbent of this position must possess strong analytical skills, with the ability to perform complex business and product set up requirement analysis in a fast-pace environment. The Benefits Des...
Posted Apr 12, 2014   —   Application Deadline: None
Healthfirst

Member Services Supervisor

Healthfirst - Lake Mary, FL
The Member Services Supervisor is primarily responsible for the quality of the telephone service provided to all internal and external customers. This position supervises the daily activities of all Member Services Senior Representatives and Member Services Representatives. Responsibilities: Review and monitor reports: Review all daily reports to manage team p...
Posted Apr 10, 2014   —   Application Deadline: None
Healthfirst

Medical Director

Healthfirst - New York, NY
Behavioral Health is changing healthcare delivery and Healthfirst is at the forefront of defining those changes. This is a significant career opportunity for a Medical Director to contribute to Behavioral Healths overall strategy and execution as Healthfirst leads the market in applying this essential element to healthcare delivery. The Medical Director will provide clinic...
Posted Apr 10, 2014   —   Application Deadline: None
Healthfirst

Nurse Care Manager CompleteCare

Healthfirst - Telecommuter
The Nurse Care Manager plans and manages patient care with members, their families or significant others, and coordinates with the Primary Care Physicians and all members of the health care team to facilitate the patient's care across continuum of care episodes. Responsibilities: Contributes to the development of patient-focused care and initiates the process in accordance wi...
Posted Apr 10, 2014   —   Application Deadline: None
Healthfirst

Network Management Representative (Long Island)

Healthfirst - New York, NY
The Network Management Representative serves as the key contact for all assigned Providers to maintain effective communication and effectively manage assigned Providers to foster and maintain sound working relationships and to ensure mutual goals are met. The position requires monitoring, tracking and reporting on set network initiatives and provider issues. It also involves input related t...
Posted Apr 10, 2014   —   Application Deadline: None
Healthfirst

Director - Dedicated Testing Organization

Healthfirst - New York, NY
The Director of Dedicated Testing Office ensures the organization processes and goals are aligned. The Dedicated Testing Office is one of the three divisions in the Strategy Management and Implementation (SMI) department and is responsible for working with all areas of the company to improve our ability to develop robust test plans. This increases our speed to market and minimizes rework th...
Posted Apr 10, 2014   —   Application Deadline: None
Healthfirst

Financial Data Analyst

Healthfirst - New York, NY
The primarily role of the Financial Data Analystwill be toprepare and review of the EMR adjustments (Excess Medical Revenue). The incumbant will also assist inmapping of the AX and GL interfaces, Assist in the UAT of the AX help stars, reconciliation of EMR and GL processes, and mapping of data warehouse tables. Responsibilities: EMR adjustments: create new adjustmen...
Posted Apr 10, 2014   —   Application Deadline: None
Healthfirst

Nurse Care Manager - Bilingual Russian

Healthfirst - Telecommuter
The Nurse Care Manager at Senior Health Partners (SHP) a Managed Long-Term Care (MLTCP) reporting to the Clinical Manager ensures high quality community-based member care through appropriate allocation of member services and resources. Monitors and evaluates effectiveness of the care plan to ensure member and caregiver satisfaction with services.The Nurse Care Manager acts as a resource to ...
Posted Apr 09, 2014   —   Application Deadline: None
Healthfirst

Reassessment Nurse

Healthfirst - New York, NY
This is a field based position for a Reassessment Nurse at Senior Health Partners (SHP) at Healthfirst. The Reassessment Nurse takes independent ownership for self-scheduling reassessment visits at intervals required by the Department of Health (DOH) to determine service needs and continued eligibility; coordinates with Care Management Team (CMT) to maintain a high level of efficient and ef...
Posted Apr 09, 2014   —   Application Deadline: None
Healthfirst

Care Manager, Utilization Management

Healthfirst - Telecommuter
The Care Manager conducts pre-certification of selected services in accordance with regulatory and departmental guidelines. The Care Manager is responsible for efficient utilization of health services and optimal health outcomes for members, as well as meeting designated metrics. Responsibilities: Evaluates and pre-authorizes request for inpatient/outpatient, specialty care, ...
Posted Apr 09, 2014   —   Application Deadline: None
Healthfirst

Care Coordinator

Healthfirst - Telecommuter
The Care Coordinator performs utilization management services in collaboration with the interdisciplinary care team to maximize the quality and cost efficiency of health care services. This is a paperless work environment requiring daily hands-on administration of multiple electronic Patient Health Information (PHI) databases and security requirement tools such as encrypti...
Posted Apr 09, 2014   —   Application Deadline: None
Healthfirst

AVP Care Management

Healthfirst - New York, NY
The Assistant Vice President of Care Management for Senior Health Partners (SHP),Healthfirstprovides leadership and direction to maximize the quality of member care and effectively manage available medical resources. Maintains high-level day-to-day operations of the care management division. Responsibilities: Supervises directors, assistant directors and all other direct repo...
Posted Apr 09, 2014   —   Application Deadline: None
Displaying results 1 - 15 of 69