Jobs at Healthfirst - Page 6

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Systems Administrator

Healthfirst - New York, NY

Responsibilities: Delivershigh quality solutions in adherence to Informatica technologies methodology Assistsdeveloping logical and physical database schemas, stored procedures,interfaces, and extensions to large enterprise proprietary solutions, primarilyfocused on the MDM initiative. Providesdesign, architecture and development support to MDM projects requiring...

Application Deadline: None

Financial Data Analyst

Healthfirst - New York, NY

Responsibilities: EMR adjustments: Create new adjustment files for any data that is not flowing through automated processes in data warehouse. These adjustments are also needed to fix any anomaly data in DWH. AX and GL interface: Controlling the data that flows from data warehouse to GL. GL and EMR reconciliation: Reconcile EMR and GL revenue and cost entries at ...

Application Deadline: None

Staff Accountant

Healthfirst - New York, NY

Responsibilities: Record all MHI expense and revenue journal entries on a monthly basis. These will include Part AB/D Revenues and Expenses, Claims, Ancillary, Incurred but not reported (IBNR) and other accruals from Accounts Payable. Staff Accountant will also be responsible for recording all expense related journal entries calculated and provided by Electronic Medical Records (EMR) ...

Application Deadline: None

Intake Nurse RN-bilingual Chinese (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

Regulatory Associate

Healthfirst - Telecommuter

Responsibilities: Duties and Responsibilities: Maintains current and accurate Medical Management documents such as policies, procedures, job aids, reference documents and letters. Ensures all tasks are performed in a timely manner in accordance with departmental and/or organization protocols. Responsible for managing work-flow...

Application Deadline: None

Intake Nurse RN -bilingual Korean (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

Medical Management Regulatory Specialist

Healthfirst - Telecommuter

Responsibilities: Duties and Responsibilities: Meets with Regulatory to organize pre-survey deliverables and conduct pre-survey reviews of materials. Interacts with and represents the Medical Management Department and external auditors. Responds to auditor requests and audits outcome results. Prepares and coordinates on-site and electronic audits...

Application Deadline: None

Director, Physician Network Management

Healthfirst - New York, NY

Responsibilities: Develop, align and leads the execution of the network strategy to drive network development and member acquisition, profitability, growth and competitive advantage in the Healthfirst service area. Actively participates on the Sales, Quality and Financial analysis leadership strategy teams. Develops a deep understanding of the provider and customers needs a...

Application Deadline: None

Provider Service Associate/Strategist (Sr. Provider Advocate)

Healthfirst - New York, NY

Responsibilities: Work within a team of Senior Provider Advocates and dedicated Senior Claims Examiners. Carry out supervisory responsibility in accordance with the organizations policies and applicable laws. Responsibilities include, but are not limited to: Responsible for conducting root cause analysis and working with staff in other business areas to assist with the resolu...

Application Deadline: None

Care Manager, RN UM-Field Bronx (Car required)

Healthfirst - New York, NY

Responsibilities: Position Responsibilities: Ensure the appropriate utilization management is applied to members in nursing facilities. Act as a liaison for Healthfirst to facilitate communication with the nursing home facility administrative and clinical staff and Healthfirst community care management prior to discharge. Ensure the ap...

Application Deadline: None

Senior QA Analyst -Data Warehouse

Healthfirst - New York, NY

Responsibilities: Duties and 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-function...

Application Deadline: None

Senior QA Analyst -Customer Relationship Management

Healthfirst - New York, NY

Responsibilities: Duties and 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-fu...

Application Deadline: None

Senior QA Analyst - Clinical & HIE

Healthfirst - New York, NY

Responsibilities: Duties and 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 requir...

Application Deadline: None

Senior QA Analyst -Corporate Systems

Healthfirst - New York, NY

Responsibilities: Duties and 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 requir...

Application Deadline: None

Healthcare Translator - Bilingual Russian

Healthfirst - New York, NY

Responsibilities: Translation services: Support the Healthfirst staff by interpreting the staff-to-member and member-to-staff conversation. Facilitate cross-cultural communication within allotted time for staff member and client Provide Care Management support to members and their families. Respond to member questions and resolve minor problems as directed. Remain accessibl...

Application Deadline: None