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Our Members’ First Line of Support

Healthfirst provides members with quality care. Our Operations team members are the first line of support directly assisting our members. These teams collaborate to streamline processes that drive positive change. Interested in joining our Operations team? Check out our available positions listed below.

Open Positions in Operations

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CCO Service Agent

NY Req ID: R020415 Remote
Duties and Responsibilities  Provides excellent quality customer service to our members and/or providers relating to all aspects of member/provider questions and issues such as eligibility, benefits, claims process, escalations, and product questions, etc. May include but is not limited to...
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Coordination of Benefits Specialist

FL Req ID: R020435 Remote
Duties & Responsibilities: Identify members who have additional coverage and update company systemsInitiate outbound calls to members and/or other primary insurers to validate insurance coverage, update all Healthfirst and/or secondary systems (including potentially CMS and State systems...
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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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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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