Healthfirst

Bilingual Spanish Field Care Coordinator Queens

NY  |  Req ID: R020966  |  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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Clinical technical Assistance Facilitator

NY  |  Req ID: R020910  |  Remote

Duties and ResponsibilitiesLeverages adult learning principles and clinical practice standards to move towards a culture of continuous technical assistance improvement and clinical capacity building with innovative learning solutionsDevelops technical assistance goals that are congruent with the...

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Support Specialist Bilingual English Mandarin or Cantonese

NY  |  Req ID: R020852  |  Remote

Duties and Responsibilities: Conduct outreaches for newly enrolled members to review current and approved services, durable medical equipment (DME) and additional requestsReview intake documents for pre-approved services and escalate discrepancies as neededComplete Welcome Onboarding and Consumer...

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Manager of Assessment Nurses

NY  |  Req ID: R020546  |  Hybrid

Duties and Responsibilities: Leads and manages daily Reassessment Nurse operations such as overseeing scheduling and staffing, providing clinical consultations, and ensuring departmental productivity goals are met in regards to quality, timeliness, accuracy, and consistency.Coordinates and...

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Bilingual Field Care Coordinator Long Island Area

NY  |  Req ID: R020783  |  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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Bilingual Field Care Coordinator 5 Boroughs

NY  |  Req ID: R020784  |  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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Bilingual Field Care Coordinator Staten Island Based

NY  |  Req ID: R020785  |  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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Bilingual Field Care Coordinator Rockland County based

NY  |  Req ID: R020786  |  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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Clinical Support Team Social Worker

NY  |  Req ID: R020916  |  Remote

Duties and Responsibilities:Completes assessment for each member related to their receipt of community based long-term care services.Develops a comprehensive care plan for each member based on assessments, counseling, environment, social support and financial status.Acts as a member advocate and...

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Bilingual Spanish Field Care Coordinator Brooklyn

NY  |  Req ID: R020957  |  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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Bilingual Fuzhounese Field Care Coordinator Travel 5 boroughs

NY  |  Req ID: R020959  |  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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CCO Service Agent (Mandarin/Cantonese)

NY  |  Req ID: R020902  |  Remote

Duties and Responsibilities Provides excellent quality customer service to our members and/or providers relating to all aspects of member/provider questions and issues such as eligibility, benefits, claims process, escalations, and product questions, etc. May include but is not limited to...

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QA Audit Manager - Operations

FL  |  Req ID: R020743  |  Hybrid

Duties & ResponsibilitiesMaintain procedures and programs to ensure Operational units meet organizational and regulatory standards for proper function, quality, and in support of enhancing Member/Provider service experiences.Experience applying critical thinking skills and problem-solving...

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Appeals Specialist

NY  |  Req ID: R020891  |  Remote

Key ResponsibilitiesResponsible for case development and resolution of non-clinical cases, such as: certain types of claim denials, member complaints, and member and provider appeals.  The end-to-end process requires the Specialist to independently:Research issuesReference and understand HF’s...

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Field Service Agent

NY  |  Req ID: R020920  |  On-site

Must be able to commute across multiple counties and boroughs: including Sullivan, Rockland, and Orange counties, as well as Manhattan and Queens boroughs. Duties/Responsibilities:Provide high-quality customer service to providers and members across all LOBs with a variety of questions and issues...

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Field Assessment RN, Bronx, NY - $10,000 Sign-on Bonus

NY  |  Req ID: R020563  |  Hybrid

Duties and Responsibilities: ·       Conducts home assessments (and virtual assessments, as needed) for prospective members and re-assessments of current members using the Uniform Assessment System (UAS); make enrollment and continued eligibility determinations by utilizing clinical expertise and...

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Hybrid Assessment RN, Bronx, NY - $7,500 Sign-On Bonus

NY  |  Req ID: R020564  |  Hybrid

Duties and Responsibilities: ·       Conducts home assessments (and virtual assessments, as needed) for prospective members and re-assessments of current members using the Uniform Assessment System (UAS); make enrollment and continued eligibility determinations by utilizing clinical expertise and...

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Director, Organizational Design and Strategic Workforce Planning

NY  |  Req ID: R017823  |  Hybrid

Duties and ResponsibilitiesPrimary designer and lead on a variety of enterprise OD and OE initiatives focused on, but not limited to, Organizational Design and Strategic Workforce Planning.Develop the enterprise approach, frameworks, and tools to implement organizational design and strategic...

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Case Manager - UM II -100% Remote

NY  |  Req ID: R020897  |  Remote

The Case Manager, Utilization Management coordinates the care plan for assigned members and conducts pre-certification, concurrent review, discharge planning, and case management as assigned. The Case Manager, Utilization Management is also responsible for efficient utilization of health services...

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Bilingual Pediatric Care Manager

NY  |  Req ID: R020904  |  Remote

**This position is 100% RemoteDuties/Responsibilities:The Pediatric Care Manager plans and manages pediatric medical and/or behavioral care with members and their beneficiaries across the continuum of care. The Care Manager is assigned to a specific product line such as PHSP, Child Health Plus,...

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