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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.

Caring for Our Members

Cyndi helps members open pathways to essential services and community entitlements for high-risk behavioral health children and their families. She collaborates with case managers to ensure that members are empowered and well-prepared to lead healthy lives and stay safe in their communities. Interested in joining our Nursing and Clinical Operations team? Check out our available positions listed below.

Open Positions in Nursing and Clinical

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Peer Support Specialist NYC (Hybrid)

New York, NY Req ID: R019831 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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Pharmacy Technician, Engagement - Hybrid NYC

New York, NY Req ID: R019932 Hybrid Clinical Services
Duties & Responsibilities:Establishes positive, collaborative, and consultative relationships with partner hospitals, community network providers, population health teams and community pharmacies.  Partners with community pharmacies to communicate medication adherence strategies,...
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Population Health Strategy Manager

New York, NY Req ID: R019721 Hybrid Clinical Services
Leads development, implementation, refinement and monitoring of short- and long-term strategies and initiatives to improve performance on quality rating programs aligned with Healthfirst’s overall corporate strategy.  Collaborates closely with Clinical, Pharmacy, Analytics, Enterprise Delivery...
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QA Auditor: Appeals and Grievances - RN or LPN

Home Office, NY Req ID: R019368 Remote Clinical Services
Duties and Responsibilities: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...
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Remote Bilingual Lead Clinical Pharmacist

Home Office, NY Req ID: R019876 Remote Clinical Services
Duties & Responsibilities:Supports initiatives to resolve gaps in care through direct provider and member outreach, collaboration with provider engagement, and leveraging our pharmacy network capabilitiesEnsures that all recommendations are consistent with the latest guidelines or otherwise...
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Remote Clinical Pharmacy Technician

Home Office, NY Req ID: R019622 Remote Clinical Services
Duties & Responsibilities:Performs review of medication lists to understand and eliminate barriers to medication therapy while serving as the member's Pharmacy Navigator to achieve proper medication adherence, minimize gaps in therapy, and prevent medication related adverse...
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Senior Dental Analyst, Pharmacy Department

New York, NY Req ID: R019694 Hybrid Clinical Services
Duties & Responsibilities:Conducts market research and understands members’ needs to ensure our current dental benefit remain competitive and sustainable.Designs interactive dashboards that provide an at-a-glance view of key performance indicators (KPIs), member feedback based on appeals and...
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Support Coordinator

Home Office, NY Req ID: R019551 Remote Clinical Services
- Review and organize CareEnhance Clinical Management Software (CCMS), Electronic Medical Records (EMR) pre-enrollment database system, and schedule assessments for field staff (Nurses and/or Enrollment 50+) to ensure daily goals for SHP, CC and PHSP are being achieved. - Section the report by...
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UAS Assessment Nurse Trainer

New York, NY Req ID: R020223 Remote Clinical Services
Duties and Responsibilities:Leverages adult learning principles and clinical practice standards to move towards a culture of continuous technical assistance improvement and clinical capacity building with innovative learning solutions.Develops technical assistance goals that are congruent with...
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Weekend Appeals and Grievances Clinical Specialist - RN, LPN or Dental Hygienist - 100% Remote

Home Office, NY Req ID: R019565 Remote Clinical Services
Duties and Responsibilities:Responsible for case development and resolution of clinical cases, such as: Pre-existing Conditions, Prior Approval, Medical Necessity, Pre-certification, Continued Stay, Reduction, Termination, and Suspension of services. The end to end process requires the Specialist...
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