Skip to content

Keeping New Yorkers Healthy

At Healthfirst, we offer comprehensive care services to our members in the community. We aim to keep our members safe, healthy, and provide attentive care. We have many opportunities available in different clinical specialties.

Where Compassion Meets Community

Assessment Nurses are pivotal to our work at Healthfirst, connecting members to the care that they need. See what a day in the life of our nurses really looks like in the communities we serve, why they love what they do, and what it means to be part of Healthfirst.

Open Positions in Nursing and Clinical

Filter jobs by

Filter jobs by

  • Job Title
  • State
  • Work Type
  • Department

Director Utilization Management

New York, NY Req ID: R021231 Hybrid Clinical Services
Duties/Responsibilities:Provide strategic direction and leadership to UM leaders and teams executing department functions including prior authorizations, concurrent reviews, and service requestsDevelop strong operational and leadership capabilities within the organization through performance...
Apply Learn more >

Document and Coding Project Coordinator

Home Office, NY Req ID: R021715 Remote Clinical Services
Duties & Responsibilities:· Responsible for expanding and improving medical records acquisition for RADV risk adjustment program· Manages relationships and effectively communicate with internal and external partners regarding quality objectives and targets as they relate to CMS audits.·...
Apply Learn more >

Field Assessment RN, Brooklyn, NY - $10,000 Sign-On Bonus (Spanish)

Field Office, NY Req ID: R021046 Hybrid Clinical Services
Duties and Responsibilities: ·       Conducts home assessments (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...
Apply Learn more >

Manager, Appeals and Grievances

New York, NY Req ID: R021619 Hybrid Clinical Services
Work ScheduleThis position requires three days per week in office (Tues/Wed/Thurs) at either: 100 Church St. New York, NY. or 1101 Greenwood Blvd. Lake Mary, FL.Duties and Responsibilities:Ensure management team is accurately monitoring performance through daily meetings, coaching, feedback,...
Apply Learn more >

Medical Peer Reviewer

Req ID: R021699 Remote Clinical Services
Duties/Responsibilities:·The Medical Peer Reviewer will assess/review requests for authorization, and claims payment, based on medical records and internal Healthfirst information and make informed clinical judgments and recommendations.·The Medical Peer Reviewer will render determinations in the...
Apply Learn more >

Mgr Clinical Appeals and Grievances

Home Office, NY Req ID: R021587 Remote Clinical Services
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...
Apply Learn more >

Mgr Medical Pharmacy Policy

New York, NY Req ID: R021657 Hybrid Clinical Services
 Duties & Responsibilities:Develops, reviews, and updates medical policies and clinical guidelines to ensure they are evidence-based and aligned with best practicesResponsible for clinical criteria updates, configuration and validation on prior authorization platform, perform testing and peer...
Apply Learn more >

Sr. Manager, Pharmacy Benefits

New York, NY Req ID: R021557 Hybrid Clinical Services
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...
Apply Learn more >

Support Coordinator

Home Office, NY Req ID: R021669 Remote Clinical Services
Duties and Responsibilities: Provides excellent quality customer service to our members and/or providers relating to authorization updates, questions/issues such as coordinating care, DME outreach, scheduling appointments, and screen assessments to identify risk factors which need closer...
Apply Learn more >
13 results