Browse Jobs
Browse fresh roles from company career pages, then filter by keyword, location, salary, skills, remote scope, and more. Each listing links back to the employer-controlled apply path when available.
Browse fresh roles from company career pages, then filter by keyword, location, salary, skills, remote scope, and more. Each listing links back to the employer-controlled apply path when available.
Healthfirst
The Service Agent is responsible for supporting Contact Center Operations (CCO) by ensuring members and/or providers receive an exceptional customer experience. This individual receives and addresses member & provider inquiries, resolves complaints, educates clients, retains mem
Healthfirst
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
Healthfirst
The Assistant Vice President (AVP) of Community Engagement is accountable for positioning Healthfirst as an engaged community health partner through high-impact, locally executed engagement strategies. Our main objective is to improve member health through a holistic approach whe
Healthfirst
The Senior Account Manager is committed to the development and supervision of a high performance provider network, through various provider engagement strategies which follow four core principles: Quality, Clinical Efficiency, Administrative Efficiency, and Population Health. The
Healthfirst
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
Healthfirst
The Senior Mgr of Clinical Eligibility will have knowledge of the current assessment process, for both Medicaid and Medicare programs. This position will support the Assessment Managers in planning, directing, and implementing processes for successful outcomes and achieving goals
Healthfirst
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,
Healthfirst
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,
Healthfirst
The Senior Analyst, 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 subject matter expert
Healthfirst
Job Profile Summary A vital role of the CMO Administration team, the Medical Peer Reviewer plays a critical role in consulting on medical necessity in the context of utilization management and ensuring adherence to internal Healthfirst and external regulations. Duties/Responsibi
Healthfirst
• The Director, HR Technology Programs leads the strategy, design, and execution of integrated HR technology solutions that enhance and analyze the employee experience while directly supporting enterprise and organizational goals. • Reporting to the VP, HR Operations, in partners
Healthfirst
T he Entitlement Advocate provides Healthfirst 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 are eligible. This enables prosp
Healthfirst
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,
Healthfirst
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
Healthfirst
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
Healthfirst
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,
Healthfirst
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
Healthfirst
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
Healthfirst
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
Healthfirst
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
Healthfirst
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
Healthfirst
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
Healthfirst
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
Healthfirst
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
Healthfirst
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