Jobs at Healthfirst
9,756 open positions
Mgr Product Mgmt & Strategy
Company: Healthfirst
Location: New York, NY
Posted Dec 21, 2024
The Manager of Product Management and Strategy is tasked with developing and improving market growth strategies for various senior market portfolios including Medicare Advantage, MAP-SNP, ISNP, FIDA, and MLTC. Key responsibilities involve identifying growth opportunities, improving membership experience, tracking regulatory updates, collaborating with finance, sales, and marketing teams, managing competitive intelligence, and ensuring profitable growth. The role requires extensive experience with Medicare products, RX experience, knowledge of the legislative environment, strong analytical and strategic skills, and proficiency in Microsoft Office tools. A graduate degree in public health, public policy, or business administration is preferred. Healthfirst offers a competitive salary and benefits package.
A&G Dismissal Specialist
Company: Healthfirst
Location: Remote
Posted Dec 21, 2024
The Appeals & Grievances (A&G) unit at Healthfirst manages member complaints, grievances, and appeals. The A&G Dismissal Specialist, responsible for a caseload, ensures timely and compliant resolution of issues. Duties include researching issues, communicating with departments, interpreting regulations, and managing productivity and quality. Minimum qualifications include healthcare experience, communication skills, customer service, organization, and Microsoft Office proficiency. Preferred qualifications include OnBase experience and a Bachelor's Degree. The role offers competitive compensation and benefits, with a hiring range varying by location. Healthfirst is an equal opportunity employer.
Payment Policy Analyst -100% Remote
Company: Healthfirst, Inc
Location: New York City, NY
Posted Dec 20, 2024
The Payment Policy Analyst role at Healthfirst involves promoting compliance and regulatory requirements, supporting the Reimbursement Operating Council, and developing new policies to improve regulatory compliance with Claims and Reimbursement guidelines. The position requires industry research, policy development, collaboration with stakeholders, and report preparation.
A&G Dismissal Specialist
Company: Healthfirst, Inc
Location: Remote
Posted Dec 20, 2024
The Appeals and Grievances (AampG) unit at Healthfirst manages member complaints, grievances, and appeals. The AampG Dismissal Specialist conducts outreach, ensures compliance with regulations, and manages a caseload. The team handles all member representatives' grievances, standard appeals, and noncontracted providers' submissions. The Specialist is responsible for researching issues, understanding claim denials, communicating with departments, interpreting regulations, dismissing cases, and managing duties within regulatory timeframes.
Analyst, Medicare Sales and Retention
Company: Healthfirst
Location: New York, NY
Posted Dec 21, 2024
Healthfirst is seeking a passionate and motivated Medicare Sales and Retention Analyst to create significant impact. The role involves providing analytical support to the Medicare Sales team, preparing reports, analyzing financial performance, and forecasting growth. Key responsibilities include collaborating with various departments, designing monthly competitive reports, and maintaining strong communication skills. The ideal candidate should possess SQL and Tableau skills, advanced Excel proficiency, and the ability to translate complex concepts. Preferred qualifications include healthcare experience and Python skills. The hiring range is competitive with comprehensive benefits.
Field-Based Pediatric Assessment Nurse - Bronx\/Westchester
Company: Healthfirst
Location: New York, NY
Posted Dec 21, 2024
The Assessment Nurse role involves conducting home and virtual assessments for Healthfirst's long-term care plans, coordinating with the Care Management Team, and ensuring members' enrollment, service needs, and continued plan eligibility. The position requires a New York State RN license, valid ID, and the ability to travel around downstate New York. Preferred qualifications include previous field-based experience, knowledge of health insurance, and language proficiency in Spanish, Russian, French, Creole, Mandarin, or Cantonese. Healthfirst offers a competitive salary and benefits package.
Driver (CDL A, B or C)
Company: Healthfirst
Location: New York, NY
Posted Dec 21, 2024
The Fleet Driver role at Healthfirst involves maintaining and operating a community outreach vehicle, ensuring its cleanliness and functionality. Responsibilities include daily inspections, minor maintenance tasks, and transporting marketing materials. The driver also sets up marketing equipment, complies with traffic regulations, and assists in administrative tasks. They are expected to build relationships within the Fleet division and Facilitated Enrollment Department, and inform management of any changes or incidents. Healthfirst offers a competitive compensation package, including benefits such as medical, dental, vision coverage, and 401k contributions.
Claims Coding Analyst
Company: Healthfirst
Location: Sebring, FL
Posted Dec 20, 2024
The Claims Coding Analyst role at Healthfirst involves maintaining claims editing systems, reviewing provider claim denials, and ensuring alignment with CMS, NYSDOH, and coding guidelines. Duties include assessing current claims edits, identifying areas for new edits, and collaborating with vendors and departments. The role requires a coding certification, high school diploma, and skills in time management, communication, and problem-solving. Healthfirst offers competitive compensation and benefits.
Field Service Agent - Bronx (Bilingual Spanish)
Company: Healthfirst
Location: New York, NY
Posted Dec 20, 2024
The Field Service Agent role at Healthfirst involves acting as a liaison between the company and its customers, handling inquiries, resolving complaints, and ensuring a positive customer experience. Duties include providing high-quality customer service, managing face-to-face encounters, de-escalating dissatisfaction, and complying with HIPAA requirements. The ideal candidate should have customer service experience, be able to handle escalated issues, and possess strong communication skills. Preferred qualifications include a degree, bilingual abilities, and healthcare contact center experience. Healthfirst offers competitive compensation and benefits.
Hybrid, Assessment RN, $7,500 Sign-On Bonus, Bronx, NY
Company: Healthfirst
Location: New York, NY
Posted Dec 20, 2024
Healthfirst is offering a hybrid Assessment Nurse role with flexible scheduling, no weekends/holidays/night shifts, and a comprehensive 4-6 week training program. The role involves visiting members in their homes to assess their health needs, coordinating with the Care Management Team, and providing community-based education. The position requires a New York State RN license, travel in the Bronx, NY, and experience with geriatrics, home care, discharge planning, or medical-surgical nursing. Compensation is competitive with a range of $71,600 - $117,470, depending on experience and location. Healthfirst is an equal opportunity employer.
Billing Operations Analyst
Company: Healthfirst
Location: New York, NY
Posted Dec 20, 2024
The Billing Operations Analyst is tasked with generating State premium revenue across all product lines, ensuring operational effectiveness, and coordinating with the IT department for State revenue submission. Key responsibilities include generating and reviewing State billing files, ensuring accurate billed records, loading data to the warehouse, preparing monthly CHP State vouchers, and reviewing GL reports. The role requires strong Excel skills, experience in billing and accounts receivable, and the ability to communicate effectively. A Bachelor's degree is preferred, but an Associate's degree is the minimum requirement. Healthfirst offers competitive compensation and benefits, and is an equal opportunity employer.
Project Management Associate
Company: Healthfirst
Location: Remote
Posted Dec 20, 2024
The Project Manager Associate represents and advances Healthfirst interests in the provider market through superior customer service, project management support, and commitment to developing a high-performance network. The role involves assisting with various provider engagement and operations strategies, creating project plans, and maintaining positive working relationships with external clients.