Jobs at Healthfirst
9,756 open positions
Web Developer
Company: Healthfirst
Location: Remote
Posted Nov 01, 2024
Hyphen, a healthcare technology company, is seeking a Front-End Developer with 3-5 years of experience in React, Redux, and TypeScript. The role involves designing, developing, and maintaining complex applications using modern web technologies. The developer will also participate in discussions to develop technical specifications, solve complex issues, and document designs. Familiarity with backend technologies, CI/CD pipelines, and Agile/Scrum methodologies is preferred. The hiring range is competitive, offering a full range of benefits including medical, dental, vision coverage, and 401k contributions.
Manager, Enrollment & Billing
Company: Healthfirst
Location: New York, NY
Posted Oct 18, 2024
The Manager, Enrollment & Billing at Healthfirst is responsible for overseeing a defined line of business, participating in the development and implementation of policies & procedures related to enrollment, billing, reconciliation, audits, and special projects. The role focuses on monitoring operational efficiency, accuracy, documentation, and reporting quality outcomes, ensuring deadlines are met, and processes are executed timely and accurately. The Manager ensures the integrity of enrollment and payment data by comparing state sources to the core system, and is responsible for monitoring employee performance, implementing improvement solutions, and hiring new staff. The role involves cross-functional collaboration with IT and Finance, and requires leadership experience in a high-volume production environment, direct supervisory experience, and understanding of member billing or enrollment processes.
Learning Delivery Specialist | Hybrid NY
Company: Healthfirst
Location: New York, NY
Posted Oct 18, 2024
The Learning Delivery Specialist will serve as an ambassador for the HF culture, leading and supporting learning projects. They will facilitate and deliver learning events, collaborate with business units, and maintain learning content materials. The role requires expertise in standard operating procedures, business process outsourcing, and multiple technology systems. The ideal candidate will have a high school diploma, previous training experience, and proficiency in Microsoft Office. A bachelor's degree in a related field, extensive experience in training or healthcare sales, and LMS experience are preferred. The role involves travel up to 50% of the time and requires a current Accident & Health, Individual/TBA - Agent (LA) or Broker (LB) license.
Manager, Actuarial Services - Medicare | Hybrid NY
Company: Healthfirst
Location: New York, NY
Posted Oct 18, 2024
The Manager of Actuarial Services is responsible for overseeing the financial performance of the Medicare line of business, providing insights and advice for business decisions, and performing various actuarial functions. Key duties include monitoring Medicare experience, supporting annual bids, assisting with IBNR analysis, researching the Medicare market, analyzing product performance, and developing business plans. The role requires a Bachelor's degree in Actuarial Science or related field, Medicare experience, data analysis skills, and the ability to manage staff and projects. Preferred qualifications include ASA and MAAA memberships, strong communication skills, and the ability to work in a fast-paced environment.
Hybrid Coding Educator
Company: Healthfirst, Inc
Location: New York City, NY
Posted Oct 19, 2024
The job description is for a Coding Educator responsible for educating providers on diagnosis coding, auditing clinical documentation, and managing the coding hotline. The role requires a strong understanding of coding guidelines, regulations, and industry standards. The ideal candidate should have a minimum of 5 years of experience in coding and education, and be certified in coding.
Bilingual Punjabi Field Care Coordinator (travel NYC area)
Company: Healthfirst
Location: New York, NY
Posted Nov 09, 2024
The Field Care Coordinator (FCC) at Healthfirst is responsible for conducting home visits for members, performing assessments, administering questionnaires, and facilitating video visits with healthcare professionals. The role involves supporting clinical teams with translation services and ensuring member needs are prioritized. The position requires a high school diploma, bilingual skills in English and Punjabi, proficiency in health information systems, and strong computer skills. Preferred qualifications include prior experience in field-based healthcare roles, experience as an interpreter/translator, and familiarity with NYC, Long Island, and lower Westchester areas. The job offers a competitive salary and benefits package, with a hiring range varying based on location.
Director, Operations Quality Assurance
Company: Healthfirst
Location: New York, NY
Posted Nov 02, 2024
The Director of Operations Quality Assurance leads an audit team that ensures business compliance and health indicators. They design and execute operational audit strategies, identify control weaknesses, and implement process improvements. The role involves close collaboration with various departments and regulatory bodies, and requires extensive knowledge of NYS and federal rules. The ideal candidate should have management experience, strong communication skills, and a background in operational audits.
Manager, Clinical Pharmacist UM
Company: Healthfirst
Location: New York, NY
Posted Nov 01, 2024
The Manager, Clinical Pharmacist UM is a hybrid role responsible for reviewing prior authorization requests for medications under medical benefits. This role involves leadership over the UM Pharmacy team, managing people, and ensuring departmental productivity goals are met. Key duties include developing clinical criteria and medical policies, supervising team operations, allocating resources, and implementing continuous process improvement. The role also involves attending meetings, conducting prior authorization reviews, and calculating billable units. The position requires working weekends, holidays, and as needed to support departmental needs. Healthfirst offers a competitive compensation package and benefits.
Hybrid Coding Educator
Company: Healthfirst
Location: New York, NY
Posted Nov 01, 2024
The Coding Educator is tasked with overseeing and educating providers on proper diagnosis coding, ensuring adherence to CMS and ICD10 CM guidelines. They audit clinical documentation, manage a coding hotline, and train providers on coding guidelines. The role involves creating presentations, job aids, and educational materials, and conducting charge audits. The educator also reviews new ICD10 coding guidelines, performs trend analyses, and develops educational programs. They maintain coding accuracy, provide feedback, and initiate corrective actions. Minimum requirements include five years of coding education experience and coding SOAP notes for various specialties, along with relevant certifications.
Manager, Network Account Manager
Company: Healthfirst
Location: New York, NY
Posted Oct 31, 2024
The Manager, Network Account Management will lead an interdepartmental Account Team, strategizing and implementing integrated strategies with high priority providers to strengthen engagement, enhance quality, and optimize membership growth and profitability. This role involves developing deep provider relationships, leading strategic planning and contracting processes, and driving profitable growth through customized solutions. The ideal candidate will have experience in provider network management, contract negotiation, and working with an executive suite.
Manager, Facilitated Enrollment
Company: Healthfirst
Location: New York, NY
Posted Oct 18, 2024
The Manager, Facilitated Enrollment (FE Manager) is responsible for overseeing the day-to-day activities of the Facilitated Enroller (FE) and Retention Specialist (RS) staff. They will manage sales and retention efforts in a specific geographic area, maintaining relationships with various external partners. The FE Manager will coach, train, and motivate staff, conduct regular meetings, and ensure all sites have necessary marketing collateral. They will also conduct site visits and manage daily assignments. The role requires experience in the healthcare industry or sales field, and preferred qualifications include team leadership experience.
Sr Actuarial Analyst
Company: Healthfirst
Location: New York, NY
Posted Nov 01, 2024
The Senior Actuarial Analyst/Forecasting role involves coordinating and performing initial analysis of quarterly forecasts for all lines of business, monitoring performance against budget/forecast, and building/maintaining forecast models. Key duties include handling data for government and regulatory entities, performing risk score and pricing analytics for Medicare products, and assisting in the Medicare bid process. Required qualifications include a degree in Actuarial Science, strong Excel skills, data analysis abilities, strategic thinking, and excellent communication skills. Preferred qualifications include passing 1-2 Actuarial Exams, experience with programming/coding, and work experience in Managed Care or Medicare/Commercial Healthcare.