Jobs at Healthfirst

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Displaying results 1 - 15 of 155

Reassessment Nurse RN

Healthfirst - New York, NY

Responsibilities: Duties and 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. Comple...

Application Deadline: None

Privacy Manager

Healthfirst - New York, NY

Responsibilities: Develop and review company policies, procedures and internal privacy audits to ensure that the application of policies and procedures are sufficient to properly safeguard Healthfirst member information. Develop Privacy Office Audit Plan that is tailored to Healthfirst departments using MS Excel and MS Word, and update accordingly as business needs and regu...

Application Deadline: None

Privacy Analyst

Healthfirst - New York, NY

Responsibilities: Conduct monthly email encryption audit to evaluate Healthfirst employees' use of the email system and determine if confidential information was sent externally with proper email Conduct monthly physical department walk-thru audits to assess whether employees are following proper procedures related to unattended computers in order to ensure confide...

Application Deadline: None

Vendor Management Specialist

Healthfirst - Lake Mary, FL

Responsibilities: Manage and delegate daily inventory workflow being performed by external vendor(s) team ensuring SLAs are achieved shifting resources as needed for enrollment and billing including, but not limited to, Medicaid e-log including weekly (Mondays) discrepancy review of MHS to the State 834 report, CHP recertification, QHP billing and Medicaid reconciliations. ...

Application Deadline: None

Data Verification Representative

Healthfirst - Lake Mary, FL

Responsibilities: Calling provider offices to verify data that is currently contained in the Healthfirst Provider Database (MHS). Providing support to the Member Services Unit by outreaching to providers that are billing Healthfirst Members through educating and instructing the provider on ways of having their claims re-examined for payment where applicable Updat...

Application Deadline: None

Field Member Services Representative

Healthfirst - New York, NY

Responsibilities: Assisting all Healthfirst members with inquiries in regards to benefits, claim payments and Healthfirst policies and procedures. Performing Primary Care Physician and address changes for members using computer application. Investigate as well as resolve member complaints and concerns. Forward all necessary issues to correct departments or send issue/concer...

Application Deadline: None

Business Analyst

Healthfirst - Lake Mary, FL

Responsibilities: Create reports and data extracts against database using MS Excel, MS Access, SAS, Qlikview and Crystal Reports. Create ad hoc reports for upper level management. Design, create, modify, support and maintain daily, weekly and monthly reports for accuracy. Monitor Business Analyst mailbox for report request and take action for completio...

Application Deadline: None

Contingent Workforce Specialist

Healthfirst - New York, NY

Responsibilities: Partner with Business leaders across multiple business units to educate and inform on policies and procedures involving the contingent workforce population. Work with IT and Facilities to coordinate access to Enterprise facilities, distribution of equipment and access to the network. Upon termination, ensure access is deactivated and equipment is returned ...

Application Deadline: None

CRM Program Manager

Healthfirst - New York, NY

Responsibilities: Partner with the business, Information Technology and implementation team to capture all aspects of the program into one program plan with the appropriate level of detail and clearly identified interdependencies. Planning, directing and coordinating project activities through the entire project life cycle (from initiation to close). This includes setting c...

Application Deadline: None

Operations Optimization Manager

Healthfirst - New York, NY

Responsibilities: Duties and Responsibilities: Support the development andoperationalizing of departmental initiatives and strategies by workingwith Operations leaders and Project Management to help define business requirements and other process documentation for such initiatives,including standards for measuring effectiveness post-implementation...

Application Deadline: None

Relationship Coordinator Supervisor (Call Center)

Healthfirst - New York, NY

Responsibilities: Review and monitor daily, weekly and monthly sales reports and performance data reports. Review all daily reports to manage team productions, workloads and identify trends. Prepares, maintains, and submits reports and records for upper management review, such as Monthly, Quarterly and annual reports. Monitor, coach and mentor the...

Application Deadline: None

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

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