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Director, Organizational Design

NY Req ID: R017823 Hybrid
Duties and ResponsibilitiesPrimary designer and lead on a variety of enterprise OD and OE initiatives with focused on organizational design.Develop the enterprise approach, frameworks, and tools informed by proven, science-based methods, with a bias for efficient, simple, user-friendly output and...
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Manager, Employee Relations | Hybrid NYC

NY Req ID: R017981 Hybrid
Duties and Responsibilities Partner with the Director, Employee Relations and HR Compliance to build a strategic Employee Relations Center of Excellence.Collaborate with and be a go-to resource for HR Business Partners for all Employee Relations issues, offering guidance on performance...
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Hospital Specialist

NY Req ID: R018315 Hybrid
Responsibilities:Managing day to day operational issues and concerns from hospital partners including but not limited to roster maintenance and claim issue root cause analysisManaging education/training regarding company-wide initiatives including but not limited to new product implementation,...
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Manager, Medicare Markets

NY Req ID: R017884 Hybrid
Duties/Responsibilities:Active analysis of complex financial reports with a P&L mindset to identify areas of performance improvement opportunity and to make informed business decisions.Leverage market and competitive intelligence reporting that summarizes and provides updates on the...
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Senior Retention Advocate

NY Req ID: R018086 Hybrid
Duties & Responsibilities:Contact member or primary caregiver by phone or letter to arrange a telephonic or in person interview to assess Medicaid/Medicare/Medicare Savings Program eligibility. Ensures all calls are in accordance to approved Healthfirst scriptsHas full and complete access to...
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Ancillary Srvs Contractor

NY Req ID: R018044 Hybrid
Manage a network of Ancillary Providers for all lines of Healthfirst's business (such as Medicaid, CHP, Medicare, and Commercial).   Monitor and audit contracted ancillary providers to ensure that accurate demographic, payment and fee schedules are loaded into the HF Provider System...
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State Program Member Engagement Specialist (FE)

NY Req ID: R017031 On-site
Identify and educate potential members on all aspects of the plan including answering questions regarding plan’s features and benefits. Responsible for identifying and assisting current members who are due to recertify their healthcare coverage for Medicaid, EP, QHP and CHP by completing member’s...
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Medicare Outside Sales Rep

NY Req ID: R017069 On-site
Duties & Responsibilities:Drive membership growth by acquiring new members while also meeting aggressive retention targets.Work directly with community-based organizations, providers, sales locations, and other sources to develop self-generated referral channels resulting in increased...
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Manager, Facilitated Enroller

NY Req ID: R017125 On-site
THIS POSITION IS LOCATED IN THE FIELD SERVING:(BROOKLYN, NY OR BRONX, NY)Manage the sales and retention efforts of the Facilitated Enrollment and Retention Specialist staff for a specific geographic area. The FE Manager will be assigned to a specific region within the borough division.Responsible...
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Bilingual Entitlement Advocate

NY Req ID: R017361 Hybrid
SHP Renewal Line: (Inbound/Outbound):Handle inbound and outbound calls to and from customers to address their needs while adhering to our service level goals.Screen all incoming calls and handles accordingly.Transfer calls to appropriate staff, unit, or department.Assist callers requesting...
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Team Lead, Entitlement Advocate

NY Req ID: R018051 Hybrid
Supervise Enrollment Medicaid Specialists. This includes observing staff in the field and conducting customer phone surveys to ensure all enrollment and Medicaid applications are completed in accordance with Company protocols and State regulations.Travel within NYC, Westchester, and Nassau...
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Senior Retention Advocate Liaison

NY Req ID: R018170 Hybrid
Duties and ResponsibilitiesConducts daily screening of applications. This includes monitoring applications submitted for deadlines, monitoring applications due to the Local Department of Social Services for faster and more accurate enrollment and conducting pre-screenings for financial...
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Senior Network Optimization Specialist

NY Req ID: R018196 Hybrid
Responsibilities:Develop tools and processes for efficient operational and reimbursement management of hospital and physician partners.Evaluate Medical Trend and other standard reporting identifying Network trend drivers and operational / financial opportunities.Collaborate with internal partners...
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Integrated Products Project Liaison

NY Req ID: R018185 Hybrid
The Project Liaison maintains control of the division’s work flow as directed by the District Managers, Senior Managers of MLTC/MAP Growth, and Director of Growth and Account Network Operations (MLTC/MAP)  while working independently to ambitiously handle multiple tasks with a fast-paced,...
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DSI Specialist

NY Req ID: R018012 Hybrid
Responsibilities:Ensure Providers' issues and needs are responded to in a timely and accurate fashion.Educate and communicate Healthfirst benefits, policies, changes, and impacts to the practice.Ability to review a Provider issue and work across internal departments to identify root cause,...
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Events Manager, Community Engagement

NY Req ID: R018239 Hybrid
Contributes to the strategic development of the CE engagements calendarResponsible for end-to-end event planning and implementationTracks Budgets and Vendor Management for Events and ConferencesManage project plans for long term and short-term InitiativesDirects the event reporting arm of the...
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Senior Retention Advocate Specialist

NY Req ID: R018169 Remote
Interprets product, procedural and regulatory information, and assists with the development of training curricula to provide field staff with available services.Administer new hire training and refresher training to the Senior Retention Advocates, Relationship Coordinators and Senior Retention...
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Medicare Sales Oversight Quality Auditor

NY Req ID: R018248 Hybrid
Duties & Responsibilities:· Gather and organize data in support of compliance audits and investigations.· Execute the timely completion of both scheduled and ad hoc operational audits and monitoring activities, across all sales channels, including delegated vendor partners.· Conduct thorough...
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