Healthfirst

Sr. 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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Dental Benefits Intern (Pharmacy Department) – 2026 Summer Internship

NY  |  Req ID: R021470  |  Hybrid

Duties & Responsibilities:Collaborate with Dental managers to gather and document requirements for dental services and initiativesConduct market research to determine effective and sustainable programs to increase preventive careSupport collection and analysis of member feedbackAssist in...

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Senior Manager, Data Engineering, Provider Analytics

TX  |  Req ID: R021591  |  Hybrid

Duties: Improve the value and utility of provider data and provider data products. Create high-impact data products in the service of our internal business and external provider partners that help improve health outcomes, experience, and satisfaction of our members, effectiveness and...

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Senior Salesforce Developer

NY  |  Req ID: R021593  |  Hybrid

Duties & Responsibilities:Analyze, design, implement customized software applications. Design, develop, and maintain complex applications. Develop unit tests and provide code coverage to accurately test business logic and functionality. Participate in developing...

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Clinical Specialist

NY  |  Req ID: R021653  |  Remote

**This position is 100% remote, M-F 8am-5:30pm scheduleDuties 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...

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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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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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Sr Account Manager Provider Complaints

NY  |  Req ID: R021562  |  On-site

Duties & Responsibilities: Serve as internal point of contact for cross-functional internal departments and teams to ensure all provider complaints are addressed and resolved within established guidelines  Partners with Sr. Complaint Analyst, and performs root cause analysis, to ensure...

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Manager, Hospital Strategic Account Management

NY  |  Req ID: R021551  |  Hybrid

Develop trusting and long-term relationships (with sponsor and non-sponsor hospitals/systems) with all key decision makers/influencers (including executive suite and managed care department personnel).Hospital/system Account expertise and deep understanding of customer and provider needsLeads the...

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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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Director, Medicare Sales Oversight

NY  |  Req ID: R021534  |  Hybrid

Duties & Responsibilities:Directs sales oversight across Healthfirst’s Growth teamServes as a liaison with internal partners and represents Growth for all compliance and quality related mattersSupports Growth Leaders as they develop their strategic priorities and new initiatives, ensuring...

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Marketing Strategy Specialist

NY  |  Req ID: R021478  |  Hybrid

Job DescriptionMonitors policies/processes and achieves marketing strategy deliverablesLeads or assists with the creation of sales collateral and member engagement materials, such as sales tools, welcome kits, newsletters, member portal, fitness rewards program, birthday emails, member mailings,...

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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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Field Sales Support Associate

NY  |  Req ID: R021039  |  Hybrid

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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Retail Operations & Community Engagement Specialist

NY  |  Req ID: R021520  |  Hybrid

Duties/ResponsibilitiesFacilitates cross-functional collaboration through regular retail site visits and daily coordination with multiple stakeholders including Sales, Member Services, EDS, Brand/Marketing, Facilities, Fleet, Technology/IT, Compliance to support existing retail sites.Identifies...

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Medicare Product Implementation & Optimization (MPIO) Intern - 2026 Summer Internship

NY  |  Req ID: R021506  |  Hybrid

Duties & Responsibilities: Assist MPIO team to Lead or participate in product-driven workgroups or provide input to product designs/enhancements and implementation plans Work with key stakeholders (including, but not limited to Regulatory, Claims Configuration, Provider Ops, Appeals &...

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Facilities Support Specialist - Lake Mary, FL - Onsite

FL  |  Req ID: R021099  |  On-site

On-site work schedule consists of reporting to our Lake Mary, FL office 5 days per week.Scope of Responsibilities:Inspect facilities and review inspection reports to determine repairs or improvements required to both facility and security related systems.Support, help develop, implement, and...

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Program Liaison IT Early Career Development

NY  |  Req ID: R021461  |  Hybrid

Duties & Responsibilities:Create template to share with Managers to solicit quarterly feedback on AssociatesCreate Visio diagrams on program performanceCreate Intake Forms, Organize Data and ensure thorough data to streamline processesCreate system to track associate participation,...

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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 – Product Owner/Business Analyst

NY  |  Req ID: R021432  |  Hybrid

This position requires three days per week in office (Tues/Wed/Thurs) at either: 100 Church Street, NYC   For this role we are looking for candidates with project, internship or work experience with business systems and processes and SDLC (Software Development Life Cycle). Candidates should have...

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