Company · 259 open roles
Careers at Healthfirst
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259 positions at Healthfirst
Community Relations Specialist - Queens/Nassau
Healthfirst·Queens, NY
Community Relations Specialists are on the front lines of improving the lives of New Yorkers by connecting people to health-insurance products and resources that create greater health equity. Community Relations Specialists are bridge-builders, connecting communities to needed in…
Appeals and Grievances Clinical Specialist
Healthfirst·Flexible / Remote
Description and Requirements Position Summary: The Appeals & Grievances (A&G) unit manages Healthfirst member complaints, grievances and appeals that are presented by the member or provider pertaining to the authorization of or delivery of clinical and non-clinical services. A&G …
HR Shared Services Senior Specialist | Hybrid NY
Healthfirst·New York, NY
Description and Requirements The Senior HR Shared Services Specialist is responsible for resolving complex, high impact inquiries and transactions across multiple tiers within the HR Shared Services (HRSS) organization. Serving as a subject matter expert (SME) this role is accoun…
Appeals and Grievances Clinical Specialist
Healthfirst·Remote - NY
Position Summary: The Appeals & Grievances (A&G) unit manages Healthfirst member complaints, grievances and appeals that are presented by the member or provider pertaining to the authorization of or delivery of clinical and non-clinical services. A&G works in collaboration with …
Hybrid Assessment Registered Nurse, Bronx, NY- $7,500 Sign-On Bonus (Spanish)
Healthfirst·New York, NY
Description and Requirements Healthfirst is New York City's largest not-for-profit health insurer, dedicated to improving health through community-driven, value-based care. For over 30 years, we have led the shift from volume to value by focusing on better outcomes, preventative …
Long Term Care Care Coordinator - Float Team
Healthfirst·Remote
Care Coordinators are responsible for performing care management services in order to support members who require assistance in navigating their health care system. The Care Coordinator supports various teams to provide excellent customer service to our NorthStar Members. Duties…
HR Shared Services Senior Specialist | Hybrid NY
Healthfirst·New York, NY
The Senior HR Shared Services Specialist is responsible for resolving complex, high impact inquiries and transactions across multiple tiers within the HR Shared Services (HRSS) organization. Serving as a subject matter expert (SME) this role is accountable for the governance and …
Field Service Agent - Bilingual Spanish - Manhattan
Healthfirst·Field - Manhattan
The Field Service Agent acts as an in-person liaison between Healthfirst and its customers. The individual is responsible for assisting customers with issues and inquiries they may have about their insurance, applications and/or claims not paid. The Field Service Agent is also re…
Senior Provider Network Contractor – Out-of-Network Provider Negotiations
Healthfirst·New York, NY
The Senior Provider Network Contractor is a highly specialized negotiator responsible for strategically engaging out-of-network healthcare providers and facilities to secure in-network participation at competitive, market-aligned rates for a health plan. This role is focused on h…
Community Office Coordinator
Healthfirst·New York, NY
The Community Office Specialist is the primary interface and front line resource for the community office. S/he will triage, research, educate, liaise and manage the community office efficiency, while tracking and providing metrics on office production. S/he works in tandem with …
Hybrid Assessment Registered Nurse, Bronx, NY- $7,500 Sign-On Bonus (Spanish)
Healthfirst·Hybrid - NY
<p>Healthfirst is New York City’s largest not-for-profit health insurer, dedicated to improving health through community-driven, value-based care. For over 30 years, we have led the shift from volume to value by focusing on better outcomes, preventative care, and cost efficiency.…
Medicare Outside Sales Rep
Healthfirst·New York, NY
The Medicare Outside Sales Representative is a top performing membership growth agent responsible for identifying, educating prospective Medicare Advantage (MA) beneficiaries in the appropriate MA plan based on prospect's needs and qualifications. The Outside Sales Rep explains p…
Senior Forecast Planning Analyst
Healthfirst·Remote - FL
The Workforce Enablement Senior Forecast Planning Analyst is responsible for leading forecasting quality, capacity planning, and performance oversight across a multichannel contact center environment, including internal operations and Business Process Outsourcing (BPO) partners. …
Information Owner
Healthfirst·Remote
In partnership with the Enterprise Delivery teams, the Information Owner is responsible for aligning the Customer Experience with the enterprise information architecture and corporate strategy. This role collaborates with enterprise and solution architects, business process owner…
Clinical Quality Manager
Healthfirst·New York, NY
Description and Requirements The Clinical Quality Manager with members and providers to ensure members receive appropriate services. This role emphasizes improving the quality of care with a focus on HEDIS, QARR and Medicare Advantage Star measures. - Interacts with hospitals, pr…
Community Relations Specialist
Healthfirst·New York, NY
Description and Requirements Community Relations Specialists are on the front lines of improving the lives of New Yorkers by connecting people to health-insurance products and resources that create greater health equity. Community Relations Specialists are bridge-builders, connec…
Vendor Partner Specialist - Clinical Support Team - Spanish Fluency
Healthfirst·Flexible / Remote
Description and Requirements The Vendor Partner Specialist is the principal contact for all vendor-related interdepartmental collaborations and is responsible for the relationship and management of business services being performed by external vendors (including off-shore). Manag…
Alfresco Solution Architect
Healthfirst·New York, NY
As key position under Enterprise Correspondence, this role will be responsible for developing and leading the architecture, design, and implementation of enterprise content management solutions built on the Alfresco platform. This role requires a strong combination of solution ar…
Sr QA Analyst, Claims
Healthfirst·Remote
The Sr QA Analyst Claims assists QA team in ensuring overall quality assurance, and is responsible for driving in-sprint automation with Java, Selenium. The Sr QA Analyst Claims is responsible for bottom-line ownership for ensuring testing of all assigned initiatives are complete…
Clinical Quality Manager
Healthfirst·New York, NY
The Clinical Quality Manager with members and providers to ensure members receive appropriate services. This role emphasizes improving the quality of care with a focus on HEDIS, QARR and Medicare Advantage Star measures. - Interacts with hospitals, providers, and members to impr…
Manager Clinical Quality Data Validation and Governance
Healthfirst·New York, NY
Description and Requirements The Manager, Clinical Quality Data Validation & Governance provides strategic and operational leadership for HEDIS clinical data validation, supplemental data governance, and quality reporting activities. This role is responsible for ensuring the accu…
Senior Manager, HR Technology & Integration | Hybrid NY
Healthfirst·New York, NY
Description and Requirements This role is responsible for stabilizing, designing, and evolving Healthfirst's HR technology ecosystem so it operates as an integrated, reliable, and scalable foundation for HR service delivery and workforce decision-making. The position owns end-to-…
Manager Clinical Quality Data Validation and Governance
Healthfirst·New York, NY
The Manager, Clinical Quality Data Validation & Governance provides strategic and operational leadership for HEDIS clinical data validation, supplemental data governance, and quality reporting activities. This role is responsible for ensuring the accuracy, integrity, compliance, …
CCO Service Agent – Bilingual - 100% Remote
Healthfirst·Remote - NY
WE ARE AN EQUAL OPPORTUNITY EMPLOYER. HF Management Services, LLC complies with all applicable laws and regulations. Applicants and employees are considered for positions and are evaluated without regard to race, color, creed, religion, sex, national origin, sexual orientation, …
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