Healthfirst

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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Healthcare Strategy Associate - Hybrid NY

NY  |  Req ID: R021801  |  Hybrid

Job DescriptionDuties and Responsibilities:· Conduct quantitative and qualitative analyses using Excel to support business and strategic decisions· Manage and track projects end-to-end, including timelines, deliverables, and stakeholder coordination· Assist in developing and executing strategic...

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State Programs Member Engagement Specialist (Facilitated Enrollment)

NY  |  Req ID: R021763  |  On-site

Engage in enrollment activities over the phone or in person through onsite coverage at hospitals, provider offices, City agencies, community business partners and Community Based Organizations (CBO’s).Complete and review all applications prior to submitting to NYSOH marketplace.Assist members...

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Senior Field Entitlement Enrollment Specialist

NY  |  Req ID: R021693  |  Hybrid

Duties & Responsibilities:Interprets product, procedural and regulatory information, and assists with the development of training curricula to provide field staff with available services.Administers new hire training and refresher training to the Senior Retention Advocates and Retention...

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Medicare Sales Support Associate

NY  |  Req ID: R021713  |  Remote

Responsible for coordinating events, presentations and enrollment opportunities, as directed by the Sales Managers, in order to execute, plan, and coordinate resources so that they can ensure a successful event.Live Healthfirst’s mission, our members are our North Star and our mission is guided...

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Director Configuration, Benefit Administration

NY  |  Req ID: R021941  |  Hybrid

This position requires three days per week in office (Tues/Wed/Thurs) at 100 Church Street, NYC Duties & Responsibilities:Develop and implement comprehensive operational strategies aimed at improving efficiency, productivity, and qualityLead initiatives to identify inefficiencies in current...

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2026 Technology Early Career Development Program - Data/Cloud Engineer

FL  |  Req ID: R021429  |  Hybrid

This position requires three days per week in office (Tues/Wed/Thurs) at Greenwood, Lake Mary, FL.For this role we are looking for candidates with project, internship or work experience with SQL and Python. Candidates should have fundamental knowledge and skills in data pipelining and cloud...

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2026 Technology Early Career Development Program – Quality Assurance/App Support

NY  |  Req ID: R021430  |  Hybrid

This position requires three days per week in office (Tues/Wed/Thurs) at 100 Church Street, NYC For this role we are looking for candidates with project, internship or work experience SQL, Java, C.  Candidates should have fundamental knowledge or skills in unit testing and databases. Candidates...

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2026 Technology Early Career Development Program – Quality Assurance/App Support

FL  |  Req ID: R021431  |  Hybrid

This position requires three days per week in office (Tues/Wed/Thurs) at 1101 Greenwood, Lake Mary, FL.For this role we are looking for candidates with project, internship or work experience SQL, Java, C.  Candidates should have fundamental knowledge or skills in unit testing and databases....

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Senior Reconciliation & Recovery Analyst

FL  |  Req ID: R021986  |  Hybrid

Duties & Responsibilities: Operate with intellectual curiosity and critically assess existing processes and procedures to identify opportunities for improvementDevelop complex analyses requiring the integration of multiple data sources, evaluation of data quality, and standardization of data...

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Process Manager Enrollment and Billing

FL  |  Req ID: R021896  |  Hybrid

This 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:Ensuring successful execution of assigned business processesForecasting, tracking, trending and reporting out operational...

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Change Manager

NY  |  Req ID: R019440  |  Hybrid

Duties & Responsibilities:Manages assigned initiatives, including workplan development, stakeholder management, change management, implementation, success measurement, and communication of project status to business stakeholders.Partners with IT and Delivery teams in the delivery of technical...

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Pharmacy Tech-1

FL  |  Req ID: R021993  |  Remote

Duties & Responsibilities:Performs review of medication lists to understand and eliminate barriers to medication therapy while serving as the member's Pharmacy Navigator in order to achieve the following:Proper Medication AdherenceMinimize any gaps in therapyPrevention of medication related...

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Clinical Pharmacist, MTM-6

NY  |  Req ID: R021967  |  Remote

Duties & Responsibilities:Support initiatives to resolve gaps in care through direct provider and member outreach, collaboration with provider engagement, and leveraging our pharmacy network capabilitiesEnsure that all recommendations are consistent with the latest guidelines or otherwise...

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Clinical Pharmacist

NY  |  Req ID: R021987  |  Remote

Duties & Responsibilities: Monitor and review prior authorization requests for medicationsCalculate appropriate billable units based on dosing based, indication, weight, BMI and other clinical considerationsDevelop clinical criteria and medical policies for the review of medicationsEnsure all...

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Manager Clinical Appeals and Grievances

NY  |  Req ID: R021587  |  Remote

Duties and Responsibilities:Manages a team of specialists, with responsibility for goal and productivity management, coaching and counseling, performance management and other leadership responsibilities as assignedProvides oversight in case research and provides advice as neededUnderstands HF’s...

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Hybrid Assessment Registered Nurse, Bronx, NY- $7,500 Sign-On Bonus (Spanish)

NY  |  Req ID: R021990  |  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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Product Owner, Corporate Business Technology

NY  |  Req ID: R021951  |  Hybrid

Define & communicate the overall vision, objectives and goals of the business. Articulate the minimum viable product needs. Create, refine, socialize and prioritize the Product backlog.Enable delivery of Product Backlog by presenting backlog to team; creating, owning and refining well-formed...

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Peer Support Specialist

NY  |  Req ID: R021592  |  Hybrid

Duties/Responsibilities:Manages designated caseload of members who could benefit from Peer Support services, care coordination, and health navigationSchedules and conducts multiple field-based visits per day (clustered by geographic areas)Completes assessments and questionnaires to identify...

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Peer Support Specialist

NY  |  Req ID: R021779  |  Hybrid

Duties/Responsibilities:Manages designated caseload of members who could benefit from Peer Support services, care coordination, and health navigationSchedules and conducts multiple field-based visits per day (clustered by geographic areas)Completes assessments and questionnaires to identify...

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