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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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Clinical Coding Retrieval Coordinator

New York, NY Req ID: R021518 Hybrid Clinical Services
Duties & Responsibilities:Responsible for expanding and improving medical records acquisition for RADV risk adjustment programPerforms medical record reviews to ensure medical records are consistent with RADV clinical documentation specificationsEngages in medical record retrieval efforts for...
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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...
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Field Assessment RN, Bronx, NY - $10,000 Sign-On Bonus (Spanish)

Field Office, NY Req ID: R021617 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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Hybrid Assessment RN, Bronx, NY - $7,500 Sign-On Bonus (Spanish)

New York, NY Req ID: R021472 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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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...
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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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Program Coordinator

Home Office, NY Req ID: R020908 Hybrid Clinical Services
Duties & Responsibilities:Verifies reward requests based on required preventive services appropriate for the member’s age, gender and other accepted demographics as outlined via the Member Reward Card Program Guidelines, HEDIS/QARR Technical Specifications, and CMS/DOH guidelinesConducts...
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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...
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