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Remote HARP LTSS Care Manager (Behavioral Health)

NY Req ID: R017877 Remote
Duties/Responsibilities:Advocates, informs, and educates beneficiaries on services, self-management techniques, and health benefits.Conducts assessments to identify barriers and opportunities for intervention.Develops care plans that align with the physician’s treatment plans and recommends...
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Remote Pediatric Care Manager

NY Req ID: R017897 Remote
Duties/Responsibilities:Advocates, informs, and educates beneficiaries on services, self-management techniques, and health benefits.Conducts assessments to identify barriers and opportunities for intervention.Develops care plans that align with the physician’s treatment plans and recommends...
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Part Time Assessment RN, Bronx, NY

NY Req ID: R018029 Hybrid
Duties and Responsibilities:  ·       Conducts in-person (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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Remote Care Manager, Long Term Care

NY Req ID: R018122 Remote
Duties/Responsibilities:Advocates, informs, and educates beneficiaries on services, self-management techniques, and health benefits.Conducts assessments to identify barriers and opportunities for intervention.Develops care plans that align with the physician’s treatment plans and recommends...
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RN/SW Care Manager - 100% Remote

NY Req ID: R017354 Remote
Duties/Responsibilities:Advocates, informs, and educates beneficiaries on services, self-management techniques, and health benefits.Conducts assessments to identify barriers and opportunities for intervention.Develops care plans that align with the physician’s treatment plans and recommends...
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Field, Assessment RN, 5k Sign-On Bonus, Bronx, NY

NY Req ID: R017466 Hybrid
Duties and Responsibilities:RN Conducts assessments for prospective members and re-assessments of current members as well as identify enrollment and or eligibility by utilizing clinical expertise and critical thinking skills. As needed, conducts assessments in settings other than home e.g....
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Bilingual Spanish Field Care Coordinator (Queens)

NY Req ID: R017620 Hybrid
Duties/Responsibilities:Schedules and conducts multiple home visits per day (clustered in small geographic areas)Supports the Healthfirst clinical team members, including UAS nurses and Care Managers, by facilitating cross-cultural communications and interpreting the employee-to-member and...
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Bilingual Spanish Field Care Coordinator (Brooklyn)

NY Req ID: R017632 Hybrid
Duties/Responsibilities:Schedules and conducts multiple home visits per day (clustered in small geographic areas)Supports the Healthfirst clinical team members, including UAS nurses and Care Managers, by facilitating cross-cultural communications and interpreting the employee-to-member and...
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Remote RN Care Manager - Diabetes

NY Req ID: R018119 Remote
Duties/Responsibilities:Advocates, informs, and educates beneficiaries on services, self-management techniques, and health benefits.Conducts assessments to identify barriers and opportunities for intervention.Develops care plans that align with the physician’s treatment plans and recommends...
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Real Time Analyst - Contact Center Operations

FL Req ID: R018139 Remote
**This position is RemoteDuties and Responsibilities Include:Monitor real-time call traffic volume for multiple queues and respond to spikes in high call volumes in relation to low staffing, average customer wait time, and call abandon percentages.Analyze trends such as call volume and AHT, and...
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Sr Clinical Policy Analyst

NY Req ID: R018172 Remote
Duties/Responsibilities:Support the Medical Policy and Clinical Utilization Management (UM) Governance Committee Chairs, committee members, and related workgroups by organizing all meeting materials (e.g. meeting minutes, presentations, etc.), tracking follow-up activities, and...
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Remote Care Manager - Pediatric Behavioral Health

NY Req ID: R018173 Remote
Duties/Responsibilities:Advocates, informs, and educates beneficiaries on services, self-management techniques, and health benefits.Conducts assessments to identify barriers and opportunities for intervention.Develops care plans that align with the physician’s treatment plans and recommends...
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Virtual Assessment Nurse, New York

NY Req ID: R018177 Hybrid
Duties/Responsibilities:                      ·       Conducts telephonic and virtual home assessments for prospective members and re-assessments of current members using the Uniform Assessment System (UAS) or other relevant department approved assessment tool; makes enrollment and continued...
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Operations Strategic Data Analyst

FL Req ID: R018202 Remote
This position is Hybrid FL or Hybrid NY 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...
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