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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

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Appeals & Grievances Clinical Specialist

Home Office, NY Req ID: R022050 Remote Clinical Services
Duties and Responsibilities:Ensures that appeals and grievances are properly classified (e.g. denial of service, denial of payment, or a grievance about a provider)Processes appeals and grievances in accordance with internal company policyEnters data into appropriate medical management...
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Care Coordinator

Home Office, NY Req ID: R021958 Remote Clinical Services
Duties and Responsibilities: Receive incoming calls from members regarding benefit questions/issues, care coordination, program inquiries, connecting to their care manager, and screening assessments to identify risk factors requiring medical interventionContemporaneously and accurately documents...
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Director, Utilization Management

New York, NY Req ID: R021977 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...
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Field Assessment Registered Nurse, Bronx, NY - $10,000 Sign-On Bonus (Spanish)

Field Office, NY Req ID: R022117 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...
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Field Assessment Registered Nurse, Bronx, NY - $10,000 Sign-On Bonus (Spanish)

Field Office, NY Req ID: R021989 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...
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Field Care Coordinator

Field Office, NY Req ID: R022157 On-site Clinical Services
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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Medical Peer Reviewer

Home Office, NY 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...
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Peer Support Specialist

New York, NY Req ID: R021592 Hybrid Clinical Services
Duties/Responsibilities:Manages designated caseload of members who could benefit from Peer Support services, care coordination, and health navigationSchedules and conducts multiple field-based visits per day (clustered by geographic areas)Completes assessments and questionnaires to identify...
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Peer Support Specialist

New York, NY Req ID: R021126 Hybrid Clinical Services
Duties/Responsibilities:Manages designated caseload of members who could benefit from Peer Support services, care coordination, and health navigationSchedules and conducts multiple field-based visits per day (clustered by geographic areas)Completes assessments and questionnaires to identify...
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Senior Manager Clinical Eligibility

New York, NY Req ID: R021813 Hybrid Clinical Services
Duties & Responsibilities:  Participates in all aspects of personnel management to ensure appropriate staffing, orientation, support, discipline, and timely performance appraisals.Meets regularly with direct reports to review goals, trends, and performance measures and to facilitate...
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Support Coordinator

Home Office, NY Req ID: R022191 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...
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Utilization Management Manager

New York, NY Req ID: R022096 Remote Clinical Services
Duties/Responsibilities:Oversees utilization management functions which include timely authorizations related to pre-certification, concurrent review, referrals, and other plan servicesDevelops and monitors goals for staff; provides ongoing feedback and coaching; conducts annual performance...
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