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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...
Collaborates with other members of the clinical team (Care Managers, Care Coordinators, Clinical Eligibility Nurses, Medical Directors, etc. During these care management visits, the FCC may perform a home environment assessment, administer health questionnaires, retrieve necessary documentation, ...
Provide support for annual Medicare bids for all Healthfirst's Medicare products. The Manager of Actuarial Services is responsible for monitoring financial performance of the Medicare line of business, providing insights and financial advice in business decisions, and all other actuarial function...
Experience in Provider Data Management, Provider Contract, and/or Provider Reimbursement Configuration. The Director, Provider Management Solution Lead will apply skills at the intersection of business and technology to plan, organize, and implement initiatives supporting our Claims and Provider ...
The Manager, Learning Delivery has responsibility for the management and execution of learning delivery for assigned business areas and establishes and/or leverages learning consistent with enterprise methodologies that effectively facilitate learning, development, and effectiveness. This role le...
The Healthcare Analyst (HCA) provides support through the research and investigation of business issues related to cost, utilization, and revenue data for multiple Healthfirst products. Basic understanding of Medicaid and Medicare programs or other healthcare plans. ...
Work experience using electronic patient health information (PHI) database usage especially UAS * Unexpired NY state driver's license or NYS ID * Knowledge of health insurance, Medicaid, Medicare and ...
Completes assessment of service needs per CMT and member's family/caregiver's request to determine ... Westchester. * For PEDS positions only: 1 year of pediatric clinical field experience and/or ...
Conducts home assessments (and virtual assessments, as needed) for prospective members and re ... Ability to travel around downstate New York which includes the 5 boroughs, Long Island, Rockland ...
Unexpired NY state driver's license or NYS DMV ID Preferred Qualifications: * Geriatrics * Home Care * Discharge Planning * Case Management * Medical Surgical Nursing * Electronic patient health ...
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 ...
... 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 ...
Work experience using electronic patient health information (PHI) database usage especially UAS * NY state driver's license * Knowledge of health insurance, Medicaid, Medicare and MLTCP * Experience ...
Previous field-based experience assessing, planning, and evaluating members care by making home or facility visits for intake/reassessments or start of care (SOC) Community Home Health Agency (CHHA ...
... long-term care plan Additional duties as assigned Minimum Qualifications: New York State RN license Ability to travel in and around Bronx, New York Unexpired NY state driver's license or NYS DMV ID ...
... assist with nursing home admission Conducts in-person Care Management visits in support of person-centered service planning Liaisons between the member and the CMT; assesses home environment and ...
Full fluency in English, Mandarin and Cantonese is required. Bilingual in English and both Mandarin and Cantonese fluency. ...
Certification or Provisional Certification as Peer Specialist or Recovery Peer Advocate. 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 h...
The Senior Business Analyst is responsible for providing guidance to other analysts in accordance with regulatory, compliance and corporate requirements and analyzing reports to direct the supervision of inventory and performance management as well as business process/Ad hoc reporting and data an...
Summary -The Data Analyst - Healthcare Analytics, collaborates with business partners to understand and address business problems through data-driven solutions. Our ideal candidate has a strong background in healthcare data analysis and is comfortable using data visualization tools and techniques...
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