Healthfirst

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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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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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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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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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 - 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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Behavioral Health Care Manager, HARP (Fluent English/Spanish)

NY  |  Req ID: R021719  |  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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Senior Field Entitlement Enrollment Specialist

NY  |  Req ID: R021693  |  Hybrid

Duties & Responsibilities:Interprets product, procedural and regulatory information, and assists with the development of training curricula to provide field staff with available services.Administers new hire training and refresher training to the Senior Retention Advocates and Retention...

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Mgr 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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