Healthfirst

Community Engagement Specialist (Queens/Nassau) or (Nassau/Suffolk)

NY  |  Req ID: R018920  |  On-site

The candidate must successfully achieve the following:Contribute to the development and implementation of strategies to build and nurture relationships with community partners, organizations, and stakeholdersCreate, maintain and foster the partnerships to drive positive impact and company...

Apply Learn more >

Share

• Email
• Facebook
• LinkedIn

Medicare Broker Relationship Associate

NY  |  Req ID: R018971  |  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...

Apply Learn more >

Share

• Email
• Facebook
• LinkedIn

Retention Advocate Team Lead

NY  |  Req ID: R018970  |  Hybrid

Duties & Responsibilities:Supervise Retention Advocates- This includes observing staff in the field (travel within NYC, Westchester and Nassau counties) and conducting customer phone audits to ensure all activities are completed in accordance with Company protocols and State...

Apply Learn more >

Share

• Email
• Facebook
• LinkedIn

MLTC Referral and Enrollment Specialist

NY  |  Req ID: R019079  |  On-site

Manage a broad base of agencies, services, and professionals as referral sources. Responsible for scouting new providers and referral sources, while meeting departmental guidelines. Must meet monthly referral goal per department guidelines. This includes:Obtaining weekly designated Licensed Home...

Apply Learn more >

Share

• Email
• Facebook
• LinkedIn

Broker Center Agent

NY  |  Req ID: R019178  |  Remote

-Provide high quality on-line and telephone assistance to all Customers - Members, Small Groups and Brokers; and Providers as required (e.g., Claim audits) -Provide high quality handling of customer inquiries, via mail, e-mail and on-line inquiries and chat sessions. -Resolve inquiries and issues...

Apply Learn more >

Share

• Email
• Facebook
• LinkedIn

Strategic Account Management Associate

NY  |  Req ID: R019277  |  Hybrid

Responsibilities:· Leading a team of Hospital Specialists in a Matrix environment· Document and recommend changes to existent processes as part of workflow redesign to align to new Strategic Account Management structure· Coordinate account activity and workflow, including but not limited to the...

Apply Learn more >

Share

• Email
• Facebook
• LinkedIn

Bilingual Call Center Rep (Spanish and/or Man/Can)

NY  |  Req ID: R019298  |  Remote

Duties and ResponsibilitiesHandling inbound and outbound calls to and from customers to address their needs while adhering to internal Service Levels standards. Creates and/or follow ups for up to 90 days on Long-Term Care (LTC) Leads and Opportunities entered in Salesforce.Create and/or follow...

Apply Learn more >

Share

• Email
• Facebook
• LinkedIn

Sr. Product Specialist

NY  |  Req ID: R019229  |  Hybrid

Participates in product driven workgroups to provide input to product designs/enhancements and implementation plans.Works closely with cross functional teams such as Enrollment & Billing, Claims, Member Services, Compliance, Sales, Finance, Clinical/Network Management, and senior management...

Apply Learn more >

Share

• Email
• Facebook
• LinkedIn

Sr QA Analyst (Remote)

FL  |  Req ID: R017525  |  Remote

• Ensure all strategic projects and operational projects meet the highest quality possible by following industry recognized QA methodologies and best practices. The candidate must have experience in structured testing methodology, with a proven ability to breakdown business...

Apply Learn more >

Share

• Email
• Facebook
• LinkedIn

Principal Cloud Database Engineer - Remote

FL  |  Req ID: R017983  |  Remote

Duties and Responsibilities:Database Design and Implementation: Design, develop, and implement cloud-based database solutions in collaboration with development teams. Create database schemas, tables, and indexes to support efficient data storage and retrieval.Cloud Database Administration:...

Apply Learn more >

Share

• Email
• Facebook
• LinkedIn

Web Developer

CT  |  Req ID: R018254  |  Remote

About HyphenHyphen is a healthcare technology company that makes it easy for health plans, providers and community organizations to share data and work together to deliver connected-care. As a subsidiary of HF Management Services, LLC, and an affiliate of Healthfirst, Hyphen was built with deep...

Apply Learn more >

Share

• Email
• Facebook
• LinkedIn

ServiceNow - Principal Engineer

FL  |  Req ID: R018193  |  Remote

Chief technical designer for ServiceNow code and architecture, responsible for overall ServiceNow code qualityProvide day-to-day administrative ServiceNow support, including advanced support via troubleshooting, implementing bug fixes and root cause analysisMonitor health, usage, and overall...

Apply Learn more >

Share

• Email
• Facebook
• LinkedIn

Senior Manager, Migrations (ETL)

NY  |  Req ID: R019039  |  Hybrid

Job Description:Lead, mentor, and manage a team of technical professionals working on migration initiatives supporting technologies SAS, Informatica, Tableau, Alteryx, Redshift, etc.Provide guidance on technical issues, career development; foster a collaborative and high-performance work...

Apply Learn more >

Share

• Email
• Facebook
• LinkedIn

Sr Mgr., Claims Modernization, Reporting & Analytics

NY  |  Req ID: R019171  |  Hybrid

Duties & Responsibilities:Works with a team of Managers and Supervisors to establish goals, priorities and deliverables of Business/ Project Analyst team.Ensures   long-term strategic and short-term tactical Operational needs for process improvement and project support are agreed upon and...

Apply Learn more >

Share

• Email
• Facebook
• LinkedIn

Director, Provider Management Solution Lead

NY  |  Req ID: R019154  |  Hybrid

Duties & Responsibilities:Assists in the development of strategic plans to ensure modern and efficient claims processing across the entire lifecycle with a focus on a unified, streamlined experience for both providers and operations staffWorks closely with technology and business leadership...

Apply Learn more >

Share

• Email
• Facebook
• LinkedIn

Sr Technical Data Product Owner/ Sr Manager

NY  |  Req ID: R018991  |  Remote

Responsibilities: This role is an integral member of the project delivery team responsible for maximizing the ROI. He/she will work with the business to understand future state needs to inform and direct the project work.  He/she is empowered by the organization to represent and make decisions...

Apply Learn more >

Share

• Email
• Facebook
• LinkedIn

Sr. Mgr., Claims Modernization, Operational Excellence

NY  |  Req ID: R019281  |  Hybrid

                In partnership with Claims Modernization leadership and key stakeholders achieve the following objectives…Develop and implement an Operational Excellence strategy for the entire Claims & Provider Payment Modernization effort, ensuring its long-term successBuild and lead a team...

Apply Learn more >

Share

• Email
• Facebook
• LinkedIn

Vendor Relationship Manager

FL  |  Req ID: R019310  |  Hybrid

Duties & Responsibilities:Oversee and monitor vendor and internal business owner relationships to ensure compliance, optimal delegate performance and achievement of business goals according to Service Level Standards and other contractual requirementsDemonstrate self-reliance, independent...

Apply Learn more >

Share

• Email
• Facebook
• LinkedIn

A&G QA Auditor

NY  |  Req ID: R019106  |  Remote

*This position is RemoteConduct quality audits of A&G items including grievances, pre-service appeals, and post service appeals utilizing appropriate sources of information; including eligibility, claims, authorizations, service forms, faxes, and any additional information required to...

Apply Learn more >

Share

• Email
• Facebook
• LinkedIn

Care Manager - Episodic UM/CM-1

Req ID: R019144  |  Remote

Duties and 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...

Apply Learn more >

Share

• Email
• Facebook
• LinkedIn