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Field Care Coordinator

NY Req ID: R022133 On-site
Duties/Responsibilities:Schedules and conducts multiple home visits per day (clustered in small geographic areas)Supports the Healthfirst clinical team members, including UAS nurses and Care Managers, by facilitating cross-cultural communications and interpreting the employee-to-member and...
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Senior Manager Clinical Eligibility

NY Req ID: R021813 Hybrid
Duties & Responsibilities:  Participates in all aspects of personnel management to ensure appropriate staffing, orientation, support, discipline, and timely performance appraisals.Meets regularly with direct reports to review goals, trends, and performance measures and to facilitate...
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Medical Peer Reviewer

NY Req ID: R021699 Remote
Duties/Responsibilities:·The Medical Peer Reviewer will assess/review requests for authorization, and claims payment, based on medical records and internal Healthfirst information and make informed clinical judgments and recommendations.·The Medical Peer Reviewer will render determinations in the...
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Director, Utilization Management

NY Req ID: R021977 Hybrid
Duties/Responsibilities:Provide strategic direction and leadership to UM leaders and teams executing department functions including prior authorizations, concurrent reviews, and service requestsDevelop strong operational and leadership capabilities within the organization through performance...
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Utilization Management Manager

NY Req ID: R022096 Remote
Duties/Responsibilities:Oversees utilization management functions which include timely authorizations related to pre-certification, concurrent review, referrals, and other plan servicesDevelops and monitors goals for staff; provides ongoing feedback and coaching; conducts annual performance...
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Lead Engineer - Agile Methodology

FL Req ID: R022160 Hybrid
Job Duties:Design and build robust, scalable, and high-performance solutions utilizing the Enterprise Agile Planning (EAP) suite of products and applications.Leverage deep expertise in the Agile Planning Platform to revolutionize application development and delivery processes, optimizing for...
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AVP, Community Engagement

NY Req ID: R021917
This is a hybrid position which consists of reporting to our 100 Church Street, NYC office 3 days per week (Tuesdays, Wednesdays & Thursdays).Responsibilities:Develop, align, and implement a community partnerships strategy that promotes Healthfirst in the targeted communities by working with...
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Director Customer Experience Strategy

NY Req ID: R021874 Hybrid
Experience Strategy Development & Execution:Lead the development and ongoing evolution of the Medicaid customer experience strategy, aligned with organizational priorities, regulatory requirements, and member needsEstablish elements of mid-term experience strategies and operational plans for...
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Fleet CDL Driver (Class A, B or C )

NY Req ID: R022067 On-site
Checks the interior and exterior of the vehicle for cosmetic and operational concerns.Performs minor maintenance tasks on the vehicle when necessary, included but not limited to daily vehicle inspections and the inspection of all engine fluids.Maintains confidentiality by keeping all potential...
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Sr. Product Specialist

NY Req ID: R022054 Hybrid
Duties & Responsibilities:•Participates in product driven workgroups to provide input to product designs/enhancements and implementation plans.•Works closely with cross functional teams such as Enrollment & Billing, Claims, Member Services, Compliance, Sales, Finance, Clinical/Network...
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Senior Network Account Manager

NY Req ID: R021405 Hybrid
· Advance Healthfirst through superior customer service focused leadership in an assigned territory and team, which will help to optimize provider satisfaction· Educate and train network representatives in key business principles around profitability, network adequacy, quality, etc.· Promote...
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