Company · 307 open roles
Careers at Healthfirst
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307 positions at Healthfirst
Category Manager – Services
Healthfirst·New York, NY
The Category Manager – Services develops and executes enterprise category strategies that optimize value, manage risk, and enable business growth through data-driven decision-making, digital procurement capabilities, and strategic supplier partnerships. Working collaboratively ac…
Clinical Coding Retrieval Coordinator
Healthfirst·New York, NY
The Clinical Coding Retrieval Coordinator is responsible for supporting Healthfirst initiatives and regulatory requirements related to RADV medical records acquisition. This position is provider facing. This position has a hybrid work location: Remote, office based, and in the f…
DSNP 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 is aligned to a Care Management team or a call center. Duties and Responsibilities: • For C…
Clinical Quality Project Coordinator
Healthfirst·New York, NY
The Clinical Quality Project Coordinator is responsible for coordinating medical record retrieval activities, including in-person retrievals at provider offices and healthcare facilities. Responsibilities include submitting and tracking record requests, monitoring and following u…
Appeals and Grievances Clinical Specialist/ Quality Of Care
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 …
Peer Support Specialist
Healthfirst·New York, NY
As a valued member of the Behavioral Health Care Management Team, the Peer Support Specialist (PSS) utilizes lived experience to model recovery and support Healthfirst members who are struggling with mental health and/or substance use disorders. The PSS works directly with member…
Clinical UM Pharmacist, NY License Required
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, …
Field Service Agent - Brooklyn - Spanish
Healthfirst·Field - Brooklyn
The Field Service Agent acts as an in-person liaison between Healthfirst and its customers. This individual receives and addresses member & provider inquiries, de-escalates and resolves complaints, educates clients, engages in member retention activities, and escalates issues req…
Support Specialist Bilingual Spanish
Healthfirst·4 Locations
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 Specialist Bilingual Mandarin Cantonese
Healthfirst·Remote - NY
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…
Medical Records Coordinator
Healthfirst·Remote
The Medical Records Coordinator supports the accuracy, integrity, and timely management of member records and clinical documentation by performing quality reviews, researching and resolving data discrepancies across multiple systems, managing State Secure File Transfer (SFT) and …
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.…
Field Assessment Registered Nurse, Bilingual Spanish, Manhattan
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, preventat…
Sr Risk Adjustment Analyst
Healthfirst·New York, NY
The Senior Healthcare Analyst provides support through the research and investigation of business issues related to cost, utilization, and revenue data for multiple Healthfirst products. The HCA will identify/monitor cost and utilization trends and the root causes in health plan …
Field Assessment Registered Nurse, Bilingual Spanish, Manhattan
Healthfirst·Bronx, NY
>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. R…
Field Assessment Registered Nurse, Bilingual Spanish, Bronx
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.…
LTC Care Coordinator (Spanish Fluency)
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…
Clinical Quality Manager
Healthfirst·New York, NY
The Clinical Quality Manager works 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. Duties & Responsibilities: • Interacts with hospita…
Staff Accountant - Hybrid NY
Healthfirst·New York, NY
Summary: • The Staff Accountant in Healthfirst's Finance department is primarily responsible for preparing monthly journal entries for all Revenue and Expenses. • The Staff Accountant will also be responsible for ensuring that there is efficient external support for the journal …
Senior Analyst, Internal Audit and Controls
Healthfirst·New York, NY
The Senior Analyst, Internal Controls will be position will be responsible for the completion assigned internal audit projects (internal audits and department projects) for Healthfirst, and for other tasks as assigned by Internal Audit Leadership. You are a fit if you have exper…
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 …
Process Manager E&B
Healthfirst·Lake Mary, FL
The Process Manager for Enrollment and Billing (E&B) leads the execution of processes that support the delivery of critical health services for Healthfirst customers. The incumbent monitors, reports, and plans for improvement across a set of core operational processes. The proces…
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 …
Senior Forecast Planning Analyst
Healthfirst·12 Locations
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. …
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