Healthfirst - IT - Administration

Manager, Medicaid Strategic Initiatives role driving profitable growth and member retention within PHSP portfolios. Requires cross-functional strategy development, market research, and regulatory analysis. Ideal for candidates with a Bachelor’s degree, strong healthcare industry knowledge, and an...

Regulatory Specialist needed to ensure compliance with CMS and NY DOH regulations in Utilization Management, Care Management, and Appeals. Requires a High School Diploma, 4+ years of healthcare experience, and strong knowledge of managed care compliance. Based in the US, this role offers medical,...

Senior Product Specialist sought to lead product optimization initiatives within a dynamic health insurance portfolio. This role requires strong analytical skills and cross-functional collaboration to drive product enhancements and end-to-end process improvements. Based in the United States, the ...

Healthcare Strategy Associate role in New York, blending analytical rigor with managed care expertise. Drive strategic initiatives through Excel modeling, cross-functional collaboration, and leadership presentations. Ideal for candidates with 1-2 years consulting or healthcare experience, strong ...

Seeking a detail-oriented **Healthcare Operations Analyst** to join our Optimization Team in the **United States**. You will analyze **provider data** workflows, perform reconciliation across systems, and implement scalable solutions to enhance operational performance. Requires advanced **Excel**...

Director of Utilization Management sought to lead clinical operations in New York, driving excellence in prior authorizations, concurrent reviews, and service requests. This role requires deep healthcare leadership experience with Medicare, Medicaid, and MLTCP, plus expertise in CMS and NYSDOH co...

Senior Regulatory Specialist – Pharmacy role ensuring CMS and DOH compliance. Monitor regulations, support implementation, and act as liaison between Pharmacy and Regulatory Affairs. Requires knowledge of state/federal requirements and High School Diploma. Bachelor’s, managed care, or pharmacy ex...

Seeking a Director of Medical Reviews in New York, NY. This role requires a licensed M.D. or D.O. with Board Certification to conduct medical necessity reviews for utilization management and appeals. You will lead quality improvement initiatives, analyze trends, and collaborate with medical depar...

Lead the Medicare customer experience strategy in this hybrid New York role. Utilize your 10+ years in CX strategy and Medicare Advantage expertise to enhance member journeys. Translate insights into initiatives with cross-functional teams, driving satisfaction and loyalty. Enjoy comprehensive be...

Lead strategic performance improvement initiatives in NYC or Lake Mary. Drive measurable outcomes in clinical and operational processes using data analysis, AI, and cross-functional leadership. This senior role offers comprehensive benefits and focuses on sustainable value delivery.