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HRBP Manager, IT – Hybrid NY

NY Req ID: R021558 Hybrid

Scope of ResponsibilitiesProactively supports the delivery of all HR initiatives and processes.Builds a strong business relationship with the internal clients and serves as a key advisor and confidante, enabling strong management and leadership for the Department.Facilitates the design and...

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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....

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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//hurs) 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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Medical Peer Reviewer

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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Senior Manager of Performance Improvement

FL Req ID: R021599 On-site

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:Identify, prioritize, and sponsor high-impact performance improvement initiativesDevelop business cases including financial...

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Senior Project Manager Utilization Management

NY Req ID: R021498 Hybrid

Duties and ResponsibilitiesLead end-to-end delivery of complex, enterprise-wide (UM transformation) initiatives focused on operational efficiency, program transformation, technology enablement, and performance improvementDrive UM modernization efforts through implementation of AI, automation, and...

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Director, Clinical Operations Children's Services

NY Req ID: R021718 Hybrid

Duties/Responsibilities:Provides leadership and directs the home and community-based services (HCBS) and case management program of the Children’s Services unit for Healthfirst members ages 0-21.Participates in all aspects of the team’s management and employee lifecycle to ensure appropriate...

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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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Clinical Peer Reviewer (Physical Therapy)

NY Req ID: R021692 Remote

Duties and Responsibilities:Review complex prior authorization, concurrent review, and retrospective cases related to Outpatient Rehab services to promote member-centered decision making that supports functional improvements and quality health outcomes.Ensure all determinations are rendered...

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2026 Summer Internship - Nursing Intern

NY Req ID: R021678 Hybrid

The program is also immersive and interactive, laying a foundation for continued leadership development. Interns do impactful work, collaborating with other interns, employees, and business leaders to solve current operational and clinical workflow challenges, strengthen member experience, and...

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Field Assessment Registered Nurse, Bronx, NY - $10,000 Sign-On Bonus (Spanish)

NY Req ID: R021617 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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Senior Manager, Pharmacy Benefits

NY Req ID: R021557 Hybrid

Duties & Responsibilities:Works collaboratively to design and manage the Healthfirst Pharmacy Benefit for all plansStrategically leads the development, planning and implementation of the annual pharmacy benefit cycle to ensure that pharmacy benefits are in-line with Healthfirst Product...

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Field Service Agent - Manhattan (Bilingual English/Spanish)

NY Req ID: R021652 On-site

Duties/Responsibilities:Provide high-quality customer service to providers and members across all LOBs with a variety of questions and issues on topics such as eligibility, benefits, claims process, escalations, and productsManage face-to-face encounters by interacting with customers to provide...

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Claims Coding Analyst

FL Req ID: R021325 Hybrid

Duties & Responsibilities: Conducts independent assessments of current claims edits to ensure comprehensive and defensible claims editing is in place across all Healthfirst product lines.Proactively identifies areas of opportunity with respect to new edits, modifications to existing edits,...

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Director, Out-of-Network Contracting

NY Req ID: R021566 Hybrid

This position requires three days per week in office (Tues/Wed/Thurs) at 100 Church St. New York, NY. ResponsibilitiesSet the enterprise strategy for Out-of-Network contracting, including rate methodologies, provider segmentation, and conversion strategies to bring high-utilization OON providers...

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AVP, Customer Experience Strategy - Medicare

NY Req ID: R021418 On-site

Principal AccountabilitiesStrategy Development and Execution:Lead the creation and implementation of the Medicare customer experience strategy aligned with business objectives and regulatory requirementsOwn and evolve the Medicare member journey portfolio, identifying key moments that matter and...

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Social Media Manager

NY Req ID: R021704 On-site

Duties and ResponsibilitiesCreative Development & Content ExecutionDevelop and lead creative concepts and content series that bring Healthfirst’s mission, programs, and community impact to life on social media.Write and refine copy tailored to social channels, ensuring alignment with brand...

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FQHC Network Account Manager

NY Req ID: R021643 Hybrid

Serve as plan liaison for physicians/physician groups in a specified geographical area. Will be the main point of contact for all plan related issues including marketing, enrollment, contracting, billing and reimbursement.Responsible for the resolution of all issues, including those identified by...

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Entitlement Advocate- Bilingual Spanish or Cantonese/Mandarin

NY Req ID: R021640 Hybrid

Duties and ResponsibilitiesHandle 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 assistance with...

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Senior Provider Network Contractor - Out of Network Provider Negotiations

NY Req ID: R021524 Hybrid

Core ResponsibilitiesStrategic Out-of-Network Provider EngagementIdentify and prioritize high-cost, high-utilization, and strategically critical out-of-network providers and facilities based on claims data, network gaps, and regulatory network adequacy requirements.Develop and execute targeted...

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Redefine your search:

Filter jobs by

HRBP Manager, IT – Hybrid NY

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

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

Medical Peer Reviewer

Senior Manager of Performance Improvement

Senior Project Manager Utilization Management

Director, Clinical Operations Children's Services

Director Utilization Management

Clinical Peer Reviewer (Physical Therapy)

2026 Summer Internship - Nursing Intern

Field Assessment Registered Nurse, Bronx, NY - $10,000 Sign-On Bonus (Spanish)

Senior Manager, Pharmacy Benefits

Field Service Agent - Manhattan (Bilingual English/Spanish)

Claims Coding Analyst

Director, Out-of-Network Contracting

AVP, Customer Experience Strategy - Medicare

Social Media Manager

FQHC Network Account Manager

Entitlement Advocate- Bilingual Spanish or Cantonese/Mandarin

Senior Provider Network Contractor - Out of Network Provider Negotiations

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