Healthfirst

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...

Director, Delivery System Engagement Network Optimization Program Management leads strategic provider network initiatives in New York, driving OON performance through data synthesis and cross-functional alignment. Requires 8+ years in healthcare strategy or network management, with expertise in d...

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...

Seeking a NYS-licensed Physical Therapist for a Clinical Peer Reviewer role in Utilization Management. Utilize your 5+ years of clinical experience to review rehab service authorizations, ensuring medical necessity and regulatory compliance. This remote US position offers full benefits and focuse...

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.

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...