Jobs at Healthfirst

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MarketPlace FE - All boroughs + Spanish, Bengali, Korean, Man/Can, OR Arabic

Healthfirst - United States of America

The Marketplace Facilitated Enroller is responsible for identifying prospective members that do not have health insurance and enroll them into one of the government programs offered by Healthfirst such as Medicaid, Child Health Plus (CHP), Essential Plan (EP) or a Qualified Health Plan (QHP). The Marketplace FE is also responsible for assisting current Healthfirst members by recertifying them i...

Sr Mgr Facilities

Healthfirst - New York, NY

The Sr Mgr Facilities is responsible for all facilities functions and operations in the HF office including managing the office infrastructure and ensuring the facility is clean, safe, secure, and operationally sound. The Sr Mgr Facilities will work with the management and staff of the various operating departments occupying the office to ensure compliance will all HIPAA, Fire Safety, and OSHA ...

Privacy Analyst

Healthfirst - New York, NY

The Privacy Analyst will serve as a generalist in the Privacy Department, performing tasks as requested by the Director of Privacy. The primary role of the Privacy Analyst will be to develop analytics to track and trend Privacy Office metrics such as disclosure activity, Privacy audit results, and others upon request. The Privacy Analyst will also be primarily responsible for learning all softw...

VP Pop Health Strategy

Healthfirst - New York, NY

The VP, Population Health is responsible for creating a unique competitive advantage by synthesizing industry and business trends, regulatory changes and internal and external best practices to develop Healthfirst's strategic approach to achieving top Quality performance across Healthfirst products, including Medicare, Medicaid, Managed Long Term Care, and Commercial products and programs. . He...

Business Analyst

Healthfirst - Lake Mary, FL

The Business Analyst is responsible for reporting, business process review and data analysis relating to activities ensuring operational effectiveness. The BA will assist management by developing and maintaining reporting tool and processes, querying and analyzing data, identifying root causes, recommending and supporting decision making. The BA owns project goals by developing project plans, e...

Claims Ops Analyst

Healthfirst - New York, NY

The Finance Operations Analyst is responsible for handling all finance operations functions which include claims, capitation, vendor refunds, and analysis.Create service forms for returned checks and vendor refunds in Macess.Post vendor refunds to the vendors' account in MHSProcess Home Medical, Interest Penalty, Member Refund, FQHC, PQRI/eRX and other incentive transa...

Team Lead, Commercial Service Center

Healthfirst - New York, NY

The primary function of the Commercial Business Service Center Team Lead is to oversee the daily activities and assignments of a team of up to 20 Commercial Business Service Center employeesDuties & Responsibilities:Ensures team of Commercial Business Service Center representatives and Commercial Service Center Liaisons maintain and/or exceed established productivity, qual...

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 Design Analyst se...

Provider Operations Outreach Specialist

Healthfirst - Lake Mary, FL

The Provider Outreach Specialist performs outbound calls to providers to ensure compliance with Access & Availability standards in accordance with State regulatory requirements. They are also expected to assist with inbound Provider Service calls as needed during time of peak call intervals and/or unexpected call volume spikes.Duties and Responsibilities: Make outbound cal...

Curriculum Development Specialist, Clinical

Healthfirst - United States of America

The Curriculum Developer Specialist participates in the design, development and maintenance of learning programs and training materials for the Clinical Management Organization (CMO), for new hires and ongoing educational programs for a mostly virtual employee population.Duties & Responsibilities: Maintain and develop business unit relationships with internal clients and p...

Healthcare Analyst

Healthfirst - New York, NY

The Healthcare Economics Analyst (HEA) provides support to the Medical Economics team within Finance through the research and investigation of business issues related to cost, utilization and revenue data for multiple Healthfirst products. The HEA will identify/monitor cost and utilization trends and the root causes in health plan trend performance and provide recommendations for solutions.

Sr Healthcare Analyst

Healthfirst - New York, NY

The Senior Healthcare Analyst is responsible for monitoring risk pool performance, communicating financial results and identifying areas of opportunity for Healthfirst and hospital senior management. The Senior Healthcare Analyst will contribute to a broad set of projects across the department.Produce and manage annual hospital performance review packetsMonitor costs and revenu...

Product Owner

Healthfirst - New York, NY

The Product Owner will help create and deliver a best-in-class business systems and operational processes. This individual will be dedicated to the Agile Work Team to interface between the operations team and the delivery of new technology and code. The role is responsible to be constantly thinking through the processes and needs of the business to support an efficient and error free process fo...

Part-Time Customer Service Rep - Spanish

Healthfirst - New York, NY

The Relationship Coordinator solicits and provides information via telephonic efforts in support of Healthfirst's Medicare Advantage Plan (MAP) and Senior Health Partners' (SHP) Managed Long-term care Plan (MLTCP).This position ensures that referral sources, prospective enrollees and/or significant others are courteously, appropriately and effectively processed through communication and follow-...

Support Coordinator

Healthfirst - United States of America

The Support Coordinator is responsible for assisting the care/case managers with non-clinical activities such as creating cases and events; providing telephonic outreach to members, providers and community-based organizations; handling member mailings; faxing clinical requests and Individual Health Care Plans on behalf of the care/case managers. The Support Coordinator is assigned to a specific...