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Conducts home assessments (and virtual assessments, as needed) for prospective members and re-assessments of current members using the Uniform Assessment System (UAS); makes enrollment and continued eligibility determinations by utilizing clinical expertise and critical thinking skills. The Asses...

Conduct assessments for prospective members and re-assessments of current members as well as identify enrollment and/or eligibility by utilizing clinical expertise and critical thinking skills. Complete assessment of members' needs due to changing conditions. Review previous nursing assessments/m...

Lead initiatives to enhance operational efficiency across all units, integrating improvements into overall workforce strategies. Collaborate with business leaders to gather requirements and support the effective implementation of workforce-related process controls. Experience as a Workforce Manag...

Manager of Strategic Operations is responsible for establishing operational objectives, work plans, and delegating assignments to subordinate managers and individual contributors responsible for managing the day-to-day functions of the Strategic Operations team.Manager is also responsible for lea...

SBH Health System, a 400 bed acute care hospital and health system in the South/Central Bronx and the primary academic affiliate of the CUNY School of Medicine seeks. BE/BC internal medicine primary care physicians. SBH was recently ranked #1 by HealthFirst Medicaid for Quality in primary care in...

The Director, Clinical Performance Optimization, is responsible for managing and improving Clinical Operations’ performance KPIs. The Director is responsible for performance optimization program development, implementation and monitoring in accordance with business needs as well as Local, State a...

The Senior Manager, Claims Modernization, Reporting & Analytics is responsible for successful implementation of strategic initiatives through overall leadership of a large team of Business and Project Analysts. Leadership experience within any area of operations (Member Services, Enrollment & Bil...

Work with the business to define methodologies that directly address their concerns; present results or deliverables to the business and provide support with confidence. Anticipate and solve strategic and high-risk business problems with broad impact on the business area by investigating problems...

Conducts in-person (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 critical thinking skills. As an Assessment...

Additional duties as assigned include functioning in a leadership role overseeing social media manager and social media designer by assigning, reviewing, and approving work that aligns with our social media goals as well as overseeing the company’s response strategy and implementation and expansi...

Healthfirst seeks an HR Project Manager (PM) who will contribute to our growth and effectiveness by implementing multiple, complex, enterprise-wide projects.This role will report to the Director, HR Program Management, and partner closely with subject matter experts and project leaders on the Lea...

The Senior Healthcare Analyst is responsible for monitoring risk pool performance, communicating financial results, and identifying areas of opportunity for Healthfirst and hospital senior management. The Senior Healthcare Analyst will contribute to a broad set of projects across the department. ...

The Senior Learning Delivery Specialist will act as an ambassador in fostering the HF culture and supporting the implementation and delivery of content relevant to enterprise initiatives, business units and strategy. This individual will lead and support learning projects and will be responsible ...

Bilingual in English and Spanish.

As a valued member of the Behavioral Health Care Management Team, the Peer Support Specialist (PSS) utilizes lived experience to model recovery and support Healthfirst members who are struggling with mental health and/or substance use disorders. While encouraging recovery planning, the PSS may ad...

The Nursing Home Liaison is expected to contribute creative solutions and take ownership of daily assignments to ensure seamless communication and systematic completion of routine and special projects. Provides administrative support to the Intake & Enrollment department by acting as liaison betw...

Unexpired NY state driver’s license or NYS ID. Completes assessment of service needs per CMT and member's family/caregiver’s request to determine service needs or any necessary adjustments. Greater New York City Area (NY, NJ, CT residents): $81,099 - $116,480.

The Assessment RN makes field assessments in and around Bronx, New York at intervals required by the Department of Health (DOH) and completes appropriate documentation to determine members’ enrollment, service needs, and continued plan eligibility. RN Conducts assessments for prospective members ...

Great opportunity for any RN background - recent nursing grads and experienced nurses are all welcome to apply! This is a Hybrid position with 2 days Remote and 3 days in the field.

Reporting to the VP, Medicare Sales and Retention, the Director of Medicare Telesales is responsible for developing and executing the Medicare Telesales strategy, both internally and with external vendors/partners. The Director orchestrates cross-functional initiatives with a strong business sens...

Duties & Responsibilities: Partners closely with operations and the business to establish, publish, and execute a strategy for PI initiatives within and between core processes. Works with PI teams to develop programs and projects based upon business user and business impacts (i.e. reduce risk/co...

This is a hybrid work schedule which consists of reporting to our 100 Church Street, NYC office 3 days per week. Scope of Responsibilities: Builds a strong business relationship with business leaders and serves as a key advisor and confidante, enabling strong management and leadership for the...

Reporting to the VP, Medicare Sales and Retention, the Director of Medicare Telesales is responsible for developing and executing the Medicare Telesales strategy, both internally and with external vendors/partners. The ideal candidate leverages her/his intelligence, business savvy, and desire for...

Experience in Provider Data Management, Provider Contract, and/or Provider Reimbursement Configuration. Assists in the development of strategic plans to ensure modern and efficient claims processing across the entire lifecycle with a focus on a unified, streamlined experience for both providers a...