Company · 307 open roles
Careers at Healthfirst
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307 positions at Healthfirst
Manager Clinical Appeals and Grievances
Healthfirst·United States
Manager Clinical Appeals and Grievances at Healthfirst. Location: United States. Role: Lead team, Oversee cases, Improve processes Requirements: Bachelor's degree; RN; experience in utilization management or appeals; leadership experience; strong communication and relationship-bu…
Change Manager
Healthfirst·Hybrid - NY
The Claims and Provider Payment Modernization Manager represents Healthfirst Operations in the support of defined claims-related and/or provider payment modernization efforts. S/he will have business oversight of capabilities as they transition from legacy models and systems into…
Senior Analyst, Total Cost of Care
Healthfirst·New York, New York, United States
Senior Analyst, Total Cost of Care at Healthfirst. Location: New York, New York, United States. Role: Analyze data, Develop models, Monitor costs Requirements: Healthcare analytics experience; 3+ years; SAS/SQL; Excel financial modeling; provider reimbursement knowledge. Category…
Clinical Pharmacist, MTM - Bilingual Spanish
Healthfirst·United States
Clinical Pharmacist, MTM - Bilingual Spanish at Healthfirst. Location: United States. Role: Support gaps, Provide outreach, Precept residents Requirements: Pharmacist licensed in good standing; MTM experience; bilingual Spanish preferred; strong clinical communication. Category: …
Clinical Pharmacist, MTM - Bilingual Spanish
Healthfirst·Remote - NY
The Clinical Pharmacist is responsible for efforts to support quality measures for both our Essential Plan and Medicare populations. The Clinical Pharmacist conducts provider and member outreach to address gaps in care measures, support medication adherence initiatives, and assis…
Change Manager
Healthfirst·New York, New York, United States
Change Manager at Healthfirst. Location: New York, New York, United States. Role: Manages initiatives, Collaborates with IT, Develops improvements Requirements: Bachelor’s degree or equivalent; strong communication; experience leading automation projects; change management; cross…
Hybrid Assessment RN, Manhattan, NY - $7,500 Sign-On Bonus
Healthfirst·Hybrid - 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, …
Sr Manager Clinical UM Operations - Hybrid NY
Healthfirst·Hybrid - NY
The Senior Manager, Clinical Utilization Management (UM) Operations is responsible for the strategic and operational leadership oversight of all utilization management activities, ensuring effective, compliant, and high-quality service delivery. This role oversees a team of peopl…
UM Pharmacy Technician-1
Healthfirst·Remote
The UM Pharmacy Technician is responsible for the intake and review of prior authorization requests for medications requested under the medical benefit. The UM Pharmacy Technician makes approval decisions and denial recommendations based on predetermined clinical criteria. They e…
Hybrid Assessment RN, Brooklyn, NY, - $7,500 Sign-On Bonus (Spanish Fluency)
Healthfirst·Brooklyn, 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.…
Hybrid Assessment RN, Bronx, NY - Sign-On Bonus $7,500 (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.…
Field Assessment RN, Bronx, NY - Sign-On Bonus $10,000 (Spanish)
Healthfirst·Bronx, 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.…
Hybrid Assessment RN, Brooklyn, NY - Sign-on Bonus $7,500 (Mandarin or Cantonese)
Healthfirst·Brooklyn, 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.…
Hybrid Assessment RN, Queens, NY - Sign-on Bonus $7,500 (Mandarin or Cantonese)
Healthfirst·Queens, 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.…
Care Manager, Bilingual Fujianese - 100% Remote
Healthfirst·Remote - NY
The Care Manager plans and manages behavioral and/or physical care with members and works collaboratively with them, their supports, providers, and health care team members. The Care Manager is responsible for applying care management principles when engaging members and addressi…
Change Manager
Healthfirst·United States
Change Manager at Healthfirst. Location: United States. Role: managing initiatives, partnering with it, developing requirements Requirements: Oversee claims and provider payment modernization programs; strong PM, change mgmt, stakeholder mgmt; experience with Agile/SAFe and healt…
Field Assessment RN, Bronx, NY - $10,000 Sign-on Bonus
Healthfirst·Bronx, 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.…
Hybrid Assessment RN, Bronx, NY - $7,500 Sign-On Bonus
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.…
Field Assessment Nurse RN, Queens, NY - $10,000 Sign-On Bonus
Healthfirst·Queens, 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.…
Customer Insight and Experience Intern \u2013 2025 Summer Internship
Healthfirst·New York, NY
Description and Requirements Healthfirst's 2025 Summer Trailblazer Internship is a 10-week paid program beginning on June 2, 2025. This is an immersive and interactive learning experience, that lays a foundation for continued leadership development. Interns do impactful work, col…
Principal Engineer, I and O - DevOps
Healthfirst·Flexible / Remote
Description and Requirements The Principal Engineer, Infrastructure and Operations is an integral driver of the Healthfirst cloud and operational excellence strategy. This role manages enterprise solutions in both public and private clouds while also utilizing tools to automate s…
Associate General Counsel
Healthfirst·New York, NY
Description and Requirements The Associate General Counsel is responsible for a wide variety of legal and regulatory activities of Healthfirst, Inc. and its subsidiaries. The position will report to and be overseen by the Vice President in charge of provider contracting and Medic…
Hybrid Assessment RN, Brooklyn, NY - $7,500 Sign-On Bonus
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.…
Field Assessment RN, Brooklyn, NY - $10,000 Sign-On Bonus
Healthfirst·Brooklyn, 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.…
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