Healthfirst - Hybrid work

Healthfirst seeks a Provider Network Account Manager in New York to drive provider engagement strategies focused on quality, clinical efficiency, and population health. You will serve as a liaison for physician groups, manage recruitment, resolve issues, and monitor performance. Ideal candidates ...

Join Healthfirst as a Broker Sales Support Associate in New York. Drive membership growth through community marketing, events, and strategic partnerships. Requires 75% travel, sales experience, and strong communication skills. Enjoy medical, dental, vision coverage, 401k, and incentive programs.

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...

AVP, Community Engagement role in New York City: Lead high-impact strategies to improve member health by addressing social determinants of health. Requires a Bachelor’s degree, strong leadership, NYC managed care expertise, and collaboration with Marketing. Drive growth and retention through comm...

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...

Join Healthfirst as a Field Assessment RN, conducting in-home health evaluations in downstate New York. Utilize your NYS RN license and clinical skills with the Uniform Assessment System (UAS) to determine member eligibility and care plans. This field-based role requires tech proficiency and offe...

Lead pharmacy benefit strategy and compliance for a major health plan in New York. This senior role requires a PharmD and expertise in Medicare Part D, PBM oversight, and regulatory guidance. You will manage a team to design flawless pharmacy benefits. We offer comprehensive medical, dental, visi...

Lead large-scale healthcare transformation initiatives as a Senior Project Manager at Healthfirst. You will modernize Utilization Management through AI, automation, and process redesign. This role requires expertise in complex project delivery within regulated environments. Drive operational effi...

Join Healthfirst as an Entitlement Advocate, supporting Medicare and Medicaid members in the New York area. You'll help secure financial entitlements through inbound/outbound calls, field visits, and electronic documentation. This hybrid role requires bilingual skills, tech proficiency, and trave...

Seeking a Network Account Manager to represent Healthfirst with FQHC providers. You will serve as the main liaison, managing relationships and resolving plan-related issues in a designated area. This role requires Medicaid/Medicare managed care experience and offers comprehensive benefits.