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General Information

Req ID
R020908
State
New York
Work Type
Hybrid

Description and Requirements

Job Profile Summary The Program Coordinator, Reward Card Program in Clinical Quality is responsible for supporting Healthfirst initiatives and regulatory requirements related to Member Rewards and Incentives, HEDIS Quality Improvement, Medicare Stars and Member Satisfaction. This position is both internal (EDS, Marketing, etc.) and external (Members, Provider, Vendor) facing.

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 guidelines
  • Conducts member and provider outreach to inform on reward guidance and status using multiple internal systems and applications
  • Collaborates with internal and external teams to track and document program requirements and implementation status
  • Documents, communicates and presents technical improvement findings and recommendations in all systems supporting Member Rewards Program
  • Provides support in creating, editing and communicating member and provider material updates
  • Additional duties as necessary


Minimum Qualifications:

  • High School/GED Diploma from an accredited institution
  • Basic knowledge of MS Word, Excel, Access, and Outlook
  • Strong organizational skills
  • Good communication (verbal and written) and interpersonal skills
  • Flexibility, reliability, and easily adaptable to any work assignments or new computer applications
  • Competent in managing responsibilities in a high-volume and fast-paced environment
  • Ability to resolve member issues with patience and courtesy


Preferred Qualifications:

  • Associate’s degree from an accredited institution + 2 Years Work Experience.
  • Experience processing reward card requests highly preferred.
  • Bilingual in English and one or more language(s): Spanish, Mandarin, Cantonese may be required based on business needs
  • Familiarity with some medical terminology.
  • Experience addressing member inquiries in a managed care environment.
  • Knowledge of CPT and ICD-9 codes.


Compliance & Regulatory Responsibilities: Noted above

License/Certification: N/A

Hiring Range*:

  • Greater New York City Area (NY, NJ, CT residents): $39,208 - $52,000

  • All Other Locations (within approved locations): $34,091 - $49,920

As a candidate for this position, your salary and related elements of compensation will be contingent upon your work experience, education, licenses and certifications, and any other factors Healthfirst deems pertinent to the hiring decision.

In addition to your salary, Healthfirst offers employees a full range of benefits such as, medical, dental and vision coverage, incentive and recognition programs, life insurance, and 401k contributions (all benefits are subject to eligibility requirements). Healthfirst believes in providing a competitive compensation and benefits package wherever its employees work and live.

*The hiring range is defined as the lowest and highest salaries that Healthfirst in “good faith” would pay to a new hire, or for a job promotion, or transfer into this role.

WE ARE AN EQUAL OPPORTUNITY EMPLOYER. HF Management Services, LLC complies with all applicable laws and regulations. Applicants and employees are considered for positions and are evaluated without regard to race, color, creed, religion, sex, national origin, sexual orientation, pregnancy, age, disability, genetic information, domestic violence victim status, gender and/or gender identity or expression, military status, veteran status, citizenship or immigration status, height and weight, familial status, marital status, or unemployment status, as well as any other legally protected basis. HF Management Services, LLC shall not discriminate against any disabled employee or applicant in regard to any position for which the employee or applicant is otherwise qualified.

If you have a disability under the Americans with Disability Act or a similar law and want a reasonable accommodation to assist with your job search or application for employment, please contact us by sending an email to careers@Healthfirst.org or calling 212-519-1798 . In your email please include a description of the accommodation you are requesting and a description of the position for which you are applying. Only reasonable accommodation requests related to applying for a position within HF Management Services, LLC will be reviewed at the e-mail address and phone number supplied. Thank you for considering a career with HF Management Services,  LLC.