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Care Coordinator - Clinical

NY Req ID: R021303 Remote
This position is 100% Remote**Prefer Bilingual Spanish or Bilingual Mandarin//CantoneseDuties and Responsibilities: Receive incoming calls from members regarding benefit questions//issues, care coordination, program inquiries, connecting to their care manager, and screening assessments to...
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QA Auditor II - Remote

NY Req ID: R021225 Remote
This position is 100% Remote. Scope of Responsibilities:Conduct moderately complex to complex quality audits of provider claims, pre-payments and post-payments including high-dollar and specialized claims across multiple lines of business, claim types and products.Audit the work of more junior...
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Director Utilization Management

NY Req ID: R021231 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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Manager, Risk Score Accuracy

NY Req ID: R021230 Hybrid
Who we are:Healthfirst was founded by a collection of major healthcare systems in the New York area to emphasize high quality of care, and better patient outcomes. We have grown into New York’s largest not-for-profit health insurer that covers members in New York City and on Long Island, as well...
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Instructional Designer

NY Req ID: R021200 Remote
Scope of Responsibilities:Partner with senior instructional designer or other learning leader to identify learning objectives, gather requirements, define outcomes, and establish evaluation measures and success metrics.Engage in a collaborative development process ensuring to partner with SME’s,...
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Manager Assessment Nurse

NY Req ID: R021008 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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Manager, Vendor Performance

NY Req ID: R021276 Hybrid
Work ScheduleThis position requires three days per week in office (Tues/Wed/Thurs) at either: 100 Church Street, NYC or 1101 Greenwood Lake Mary, FL.Duties & Responsibilities:Ensure successful onboarding and offboarding of Healthfirst delegated vendorsContinuously review and update vendor...
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