Company · 307 open roles
Careers at Healthfirst
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307 positions at Healthfirst
Senior Manager, Fee Schedules, Total Cost of Care
Healthfirst·New York, NY
The Senior Manager, Fee Schedules, Total Cost of Care, will develop analyses and tools to help monitor financial performance and provide analytic insights into all products offered within the Healthfirst portfolio. This key role will serve as healthcare analytics and data subje…
Sr Claims Coding Analyst
Healthfirst·Remote
The Senior Claims Coding Analyst – Dispute Triage & Optimization serves as a coding subject matter expert and triage coordinator responsible for optimizing the disposition of provider disputes across populations of claim scenarios. The Senior Analyst uses coding expertise and cla…
Manager, Fleet
Healthfirst·New York, NY
The Manager, Fleet is responsible for the day-to-day management and oversight of Healthfirst MU’s (Mobile Units) or Cargo Fleet Drivers, who are responsible for driving Healthfirst owned marketing vehicles utilized by our Sales Force within the NYC boroughs, Hudson Valley and Lon…
Support Coordinator
Healthfirst·Remote
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 an…
Support Coordinator
Healthfirst·Remote
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 an…
Hospital Specialist
Healthfirst·Hybrid - NY
The Hospital Specialist is the point person responsible for ensuring maximization of operational efficiency between Healthfirst and our network hospitals. This role is required to report onsite to our 100 Church Street office Tuesday-Thursday. Responsibilities: • Managing day t…
TL QA Auditor
Healthfirst·Hybrid - FL
The Quality Audit (QA) Team Lead is responsible for managing the daily activities of the Quality Audit Team. The QA Team Lead is also responsible for performing internal quality audits of operational processes for internal employees and outsourced vendors to ensure compliance wit…
AVP Payment Configuration
Healthfirst·Hybrid - NY
The Assistant Vice President (AVP) of Provider Payment partners with senior leadership to design and implement the methods and procedures essential for successful claim & benefit configuration, provider onboarding, and maintenance of provider records. The incumbent provides strat…
Senior Pharmacy Compliance Reporting Analyst
Healthfirst·Flexible / Remote
Description and Requirements Healthfirst believes that every New Yorker deserves access to the best available healthcare. As one of New York's highest quality not-for-profit health insurers serving close to two million New Yorkers, we make this a reality for our members. Founded …
Field Entitlement Advocate
Healthfirst·New York, NY
Description and Requirements The Entitlement Advocate provides Healthfirst's Medicare Advantage Plan(MAP), Managed Long-Term Care Plan(LTC), Dual eligible Medicare Plan and Nursing Home members and prospects with obtaining and retaining of financial entitlements for which they ar…
LTC Care Coordinator
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…
Sr Business Analyst -PDO
Healthfirst·New York, NY
The Senior Business Analyst- Provider Data Operations (PDO) is responsible for business process review, data analysis and reporting as it relates to activities which ensure operational effectiveness. Incumbents assist management by coordinating workflow and working directly with …
Clinical Quality Specialist
Healthfirst·100 Church Street
The Clinical Quality Specialist is responsible for performing Healthcare Effectiveness Data and Information Set (HEDIS) medical record review, supplemental data validation, data abstraction, and clinical data quality activities using internal and external clinical data sources. T…
Manager, Medicare Digital Growth and Lead Management
Healthfirst·New York, NY
Description and Requirements The Manager, Medicare Digital Growth and Lead Management - Digital Sales Growth & Enterprise Lead Management - will help establish, grow, and optimize Healthfirst's Medicare Digital sales channel while advancing enterprise lead management strategy acr…
Field Entitlement Advocate
Healthfirst·Field - Brooklyn
<p>The Entitlement Advocate provides Healthfirst's Medicare Advantage Plan(MAP), Managed Long-Term Care Plan(LTC), Dual eligible Medicare Plan and Nursing Home members and prospects with obtaining and retaining of financial entitlements for which they are eligible. This enables p…
Senior Pharmacy Compliance Reporting Analyst
Healthfirst·Remote
Healthfirst believes that every New Yorker deserves access to the best available healthcare. As one of New York’s highest quality not-for-profit health insurers serving close to two million New Yorkers, we make this a reality for our members. Founded more than 30 years ago by the…
Software Production Support Lead
Healthfirst·Remote - NY
As a Software Production Support Lead, you will ensure the stability, availability, and performance of our products. You will collaborate with cross-functional teams to investigate complex technical issues, support users, and contribute to the continuous improvement of our proces…
Manager, Medicare Digital Growth and Lead Management
Healthfirst·Hybrid - NY
The Manager, Medicare Digital Growth and Lead Management — Digital Sales Growth & Enterprise Lead Management - will help establish, grow, and optimize Healthfirst’s Medicare Digital sales channel while advancing enterprise lead management strategy across Medicare distribution cha…
Claims Configuration and Quality Audit Analyst | Hybrid NY
Healthfirst·Hybrid - NY
The Configuration Analyst of Office365 is responsible for managing, administering and governing the Office 365 global tenants, including SharePoint Online, MS Teams, OneDrive and other applications within the Office365 suite. The resource will work in a dedicated team focused on …
Manager, Clinical Pharmacist UM
Healthfirst·Hybrid - NY
The Manager, Clinical Pharmacist UM is responsible for the review of prior authorization requests for medications requested under the medical benefit. Additionally, the role is responsible for the hands-on leadership over the UM Pharmacy team and all related people management res…
Total Cost of Care, Manager
Healthfirst·New York, 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, …
LTC Care Coordinator
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…
Director - Business Contracting
Healthfirst·New York, 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, …
Hyphen Client Success Specialist
Healthfirst·Hybrid - CT
We are seeking a proactive and detail-oriented Client Success Specialist to join our growing team. This role is ideal for someone who thrives in a client-facing environment, enjoys problem-solving, and is passionate about delivering exceptional service. The successful candidate w…
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