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Legal Intern

NY Req ID: R019290 Hybrid
Responsibilities:This role will focus primarily on provider and vendor contract drafting, corporate governance, evidence collection for litigation and pre-litigation disputes, as well as administrative law hearing preparation and appearances.  The legal intern will assist and work directly with...
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Manager Enrollment and Billing

NY Req ID: R020160 Hybrid
Duties and Responsibilities:Oversee the enrollment process, ensuring timely and accurate processing of new and modified enrollments, renewals, and terminations.Collaborate with internal teams (e.g., sales, customer service, compliance) to ensure seamless management of members.Monitor ,report, and...
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Community Engagement Project Specialist

NY Req ID: R020272 Hybrid
The Healthfirst Community Engagement Department (CE) supports enterprise health equity initiatives, membership growth and retention efforts, corporate and social responsibility, and internal event production.  We build trust in Healthfirst in the communities we serve and collaborate strategically...
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Healthcare Analyst - Hybrid NY

NY Req ID: R020518 Hybrid
More about the team, and the role: Transactional healthcare data is the lifeline for our value-based payment model. The Risk Adjustment & Encounters Reporting team is unique, as it relies on establishing workstreams and developing partnerships across the care continuum to ensure that the...
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Manager, Medicare Commissions

NY Req ID: R020254 Hybrid
Duties & Responsibilities:Has oversight of the entire broker appointment process to ensure proper completion of contracts and marketing agreements.Responsible for reviews of credentialing paperwork, confirmation of active licenses, and assignment of specific coding to be assigned to all new...
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QA Auditor, Appeals and Grievances

NY Req ID: R020413 Remote
Conduct 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 complete the request. Analyze...
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Product Owner-Technical

NY Req ID: R020264 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 backlog.Enable delivery of Product Backlog by presenting backlog to team; creating, owning and refining well-formed...
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Care Manager

NY Req ID: R019504 Remote
**This position is 100% RemoteDuties 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...
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Care Manager, Remote

NY Req ID: R020332 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...
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Care Manager - DSNP - 100% Remote

NY Req ID: R020511 Remote
Duties and Responsibilities:The care manager will be responsible for dual eligibility plan.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...
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External Communications Manager

NY Req ID: R020502 Hybrid
Duties/Responsibilities In partnership with the Director of External Communications, manage the strategic planning of the entire content life cycle, ensuring alignment with specified objectives and timelinesResponsible for content and production of regular Government Affairs newslettersEvaluates...
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