Company · 307 open roles
Careers at Healthfirst
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307 positions at Healthfirst
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…
Fleet Driver
Healthfirst·New York, NY
The Fleet Driver is responsible for maintaining an efficient, well organized community outreach vehicle (COV) and cargo van at the assigned Healthfirst marketing location. The Driver is accountable for the day to day operations on the assigned COV/cargo van, liable for all market…
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…
AI Infrastructure Architect
Healthfirst·Lake Mary, FL
The AI Infrastructure Architect role at Healthfirst works to establish sustainable design principles across infrastructure systems, cloud platforms, enterprise integration patterns, and emerging AI platform capabilities. This person will work internally across Infrastructure & Op…
Senior Manager, Product Management and Strategy
Healthfirst·New York, NY
The Senior Manager of Product Management and Strategy is responsible for working cross functionally to develop, assist in execution, and continuously improve upon a market growth strategy that supports a profitable growth across the entire Medicaid/Medicare portfolio. • Support …
Manager, Clinical Appeals & Grievances
Healthfirst·Remote - NY
The Appeals & Grievances (A&G) Weekend Inventory Manager is responsible for managing and monitoring appeal inventory for a team of A&G Clinical Specialist. This is a full-time role, expected to work 4 days a week and must be able to work the weekends (i.e. Fri-Mon or Thurs-Sun). …
Senior Instructional Designer | Hybrid NY or FL
Healthfirst·Hybrid - NY
The Senior Instructional Designer is responsible for the design and development of holistic, multi-modal best-in-class programs that align to the Healthfirst culture with an emphasis in digital transformation. The Sr. Instructional Designer will focus on leading efforts to apply …
Ancillary Services Network Account Manager
Healthfirst·New York, NY
Under the direction of the Manager of Ancillary Services, the Ancillary Services Contractor develops and maintains an Ancillary provider network that ensures Healthfirst members have superior access to the highest quality by focusing efforts on lowering claims costs, improving th…
Learning Delivery Specialist – Clinical RN
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, …
Cyber Security Engineer - Data Security
Healthfirst·100 Church Street
We are seeking a Cyber Security Engineer – Data Security to design, implement, and continuously improve security capabilities that protect sensitive data across the enterprise. This is a hands-on security engineering role focused on understanding where sensitive data resides, h…
Field Service Agent - Brooklyn - Spanish
Healthfirst·New York, NY
Description and Requirements 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 activit…
LTC Care Coordinator (Chinese Fluency)
Healthfirst·Flexible / Remote
Description and Requirements 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 o…
Manager, Production Support
Healthfirst·Sebring, FL
Description and Requirements The Manager, Production Support supports the delivery of Healthfirst's data platforms and solutions by leading day-to-day execution for a defined set of data products, pipelines, or platform capabilities. This role partners with product owners, archit…
Field Service Agent - Brooklyn - Spanish
Healthfirst·Brooklyn, NY
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…
TL QA Auditor
Healthfirst·Sebring, FL
Description and Requirements 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 ven…
Manager, Fleet
Healthfirst·New York, NY
Description and Requirements 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 bo…
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…
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…
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…
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