Healthfirst

Community Office Coordinator- Elmhurst/Fordham

NY  |  Req ID: R022108  |  On-site

Job DutiesImprove overall member experience and reduce waiting time in order to expedite traffic flowRegister and educate members in the HF Member portal (access online services)Audit and Review applications to ensure quality and reduce rejectionsConduct training to Representatives during team...

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Medicare Inside Sales Representative

NY  |  Req ID: R022024  |  Hybrid

Duties & Responsibilities: Stakeholder Engagement & Brand Representation Promotes hyper-local value propositions, acting as the Healthfirst ambassador in every phone call and enhancing Healthfirst brand and value propositionsDelivers effective sales presentations over the phone to...

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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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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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Lead Enterprise Process Architect

NY  |  Req ID: R021629  |  Hybrid

This role establishes the methodologies, standards, and governance required to decompose business capabilities into reusable process components that can be executed by human workers, AI agents, digital workers, or hybrid human-agent teams. The role advances process architecture practices for the...

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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...

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Principal Engineer, Cloud Systems

FL  |  Req ID: R022044  |  Remote

Duties & Responsibilities:Works vertically and horizontally across the Infrastructure and Operations portfolio supporting private/public cloud systems, operating systems, middleware, storage, database platforms, and other key infrastructure products.Assists department leadership by providing...

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Enterprise Data Architect

NY  |  Req ID: R022066  |  Remote

Plays a leadership role in the definition and execution of the Information Management roadmap.Supports Enterprise Data Architecture roadmap by managing architectural runway for enterprise data model, enterprise data store/warehouse, information management, and advanced data analytics...

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Product Owner, PDO

NY  |  Req ID: R021844  |  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 backlogEnable delivery of Product Backlog by presenting backlog to team; creating, owning and refining well-formed...

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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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Clinical Pharmacy Technician

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 Pharmacy Technician

FL  |  Req ID: R021994  |  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

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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Appeals and Grievances Clinical Specialist

NY  |  Req ID: R021907  |  Remote

Duties and Responsibilities:Responsible for case development and resolution of clinical cases, such as: Pre-existing Conditions, Prior Approval, Medical Necessity, Pre-certification, Continued Stay, Reduction, Termination, and Suspension of services. The end to end process requires the Specialist...

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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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Hyphen Client Success Specialist

CT  |  Req ID: R022090  |  Hybrid

Key ResponsibilitiesClient Implementation & Product SupportResponsible for identifying, recruiting and onboarding new clientsSupport successful client implementations, ensuring clients have an excellent customer experience, adopt our tools and perform at the highest levelsDocument client...

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