Jobs at Healthfirst

156 job openings

Save This Search

Refine Your Search

Show more Show less
Displaying results 1 - 15 of 156

VP, Clinical Analytics and Informatics

Healthfirst - New York, NY

Responsibilities: Overseesthe management of all data management, operational reportingand predictive and outcomes analysis for all Clinical programs (Care Management, Utilization Management and Clinical Quality/HEDIS )across all Healthfirst lines of business in order to support achievement of Healthfirsts Population Health goals. Partners with analytic leads fr...

Application Deadline: None

Marketing Manager

Healthfirst - New York, NY

Responsibilities: Manage and execute integrated marketing campaigns that tie in measurable benchmarks that generate ROI (return on investment). Campaign messages revolve around the member lifecycle and incorporate traditional, digital, direct marketing, grassroots marketing, and other innovative ways to reach and engage the customer. Implement and execute retenti...

Application Deadline: None

Associate Enterprise Business Analyst

Healthfirst - New York, NY

Responsibilities: Analyzes, gathers, and reports on developments and changes and changes in the IT Business Management vertical as it relates to the IT Intake Management Process, IT Project Deliverables and overall planning of service and solution delivery. Ensures issue description is accurate and actionable by engaging constituents for more information where necessary Pro...

Application Deadline: None

Non-Clinical Coordinator, Appeals and Grievances

Healthfirst - Ny, Telecommuter

Responsibilities: Ensures appeals and grievances are categorized and processed within New York State and Federal time frames. Enters all appeals and grievances in the Units software tracking system. Identifies potential quality issues and initiates referrals to the Quality Improvement Department. Requests waivers from providers for non-clinical Medicar...

Application Deadline: None

Ancillary Services Contractor

Healthfirst - New York, NY

Responsibilities: Manage a network of Ancillary Providers for all lines of Healthfirst's business (such as Medicaid, CHP, Medicare, and Commercial). Monitor and audit contracted ancillary providers to ensure that accurate demographic, payment and fee schedules are loaded into the HF Provider System correctly. Resolve configuration issues by identifying root causes in order to prevent ...

Application Deadline: None

Intake Nurse, RN (Car Required)

Healthfirst - New York, NY

Responsibilities: Conducts enrollment assessments of prospective members in their homes; makes enrollment decisions and develops initial plans of care by utilizing clinical expertise and critical thinking skills. As needed, will conduct assessments in settings other than home as needed, e.g. skilled nursing facilities Determines clinical eligibility of prospective members f...

Application Deadline: None

Care Manager, UtilizationManagement

Healthfirst - Telecommuter

Responsibilities: Duties and Responsibilities: Evaluates and authorizes request for personal care services, specialty care, home care,Durable Medical Equipment (DME), outpatient rehab and transportationservices from network and out-of-network providers in accordance withdepartmental guidelines. Collaborates directly with the medical team relatedt...

Application Deadline: None

Team Lead II

Healthfirst - Lake Mary, FL

Responsibilities: Duties and Responsibilities: Ensure enrollment deadlines are met, while meeting production and quality standards. Approve overtime and staffing needs for front line staff. Act as departmental point of contact for departments and external vendors. Assist in developing metrics to report trending, root cause i...

Application Deadline: None

Compensation Analyst

Healthfirst - New York, NY

Responsibilities: Manage day-to-day administration of compensation programs, including job evaluations, providing client support, running reports for management and providing support for ad hoc projects; Assist with the design, implementation and administration of innovative compensation programs and policies and ensure that all plans are compliant with state and federal la...

Application Deadline: None

Senior Business Analyst

Healthfirst - Lake Mary, FL

Responsibilities: Duties Responsibilities: Research, analyze and interpret a wide variety of data and provide assistance to Business and Operation Analysts in the development of indicators, measures, and management reporting. Create reports and data extracts against database using MS Access, SAS, Qlikview Crystal Reports, and MS Excel. ...

Application Deadline: None

VP, Clinical Operations Excellence

Healthfirst - New York, NY

Responsibilities: Unifies, develops and expands Clinical Services operational units ensuring efficiency and effectiveness of processes and high quality service to support Care Management, Utilization Management, Clinical Quality, and Population Health teams. Ensures clinical teams are operating within regulatory requirements and industry best practices via his/...

Application Deadline: None

Support Coordinator_Complete Care

Healthfirst - Telecommuter

Responsibilities: Duties Responsibilities: Monthly outreach calls to members. Communication with service providers regarding authorization (but not limited) to: calls tocommunity-based organizations, calling providers with the pre-certification number, entering cases, emergency/crisis member calls and other inquiries. Assesses calls an...

Application Deadline: None

Social Worker Complete Care

Healthfirst - Telecommuter

Responsibilities: Assess Member's physical, emotional and social needs. Formulate and coordinate plan of care with member and appropriate others to ensure optimal coordination of community based treatments and collateral services, timely access to care and appropriate utilization of resources. Collaborate with inpatient treatment team to prevent gaps in care and ...

Application Deadline: None

Healthcare Analyst - Hospital Reporting

Healthfirst - New York, NY

Responsibilities: Provide support to the Provider Organizations performance improvement work groups. Monitor costs and revenue trends for Provider Organizations and assist in understanding trends. Understand and analyze impacts of new program changes. Responsible for creating, modifying, and updating analysis for Provider Organizations. Resp...

Application Deadline: None

Scheduling Liaison

Healthfirst - New York, NY

Responsibilities: Duties and 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...

Application Deadline: None