Healthfirst

Seeking an Ancillary Services Network Account Manager to develop and maintain a high-quality provider network for Healthfirst. You will manage contracts, resolve claims issues, and ensure network satisfaction across Medicaid, Medicare, and Commercial lines. This role requires managed care experie...

Join Healthfirst as a Field Care Coordinator, conducting essential home visits for members in downstate New York. This bilingual role requires travel and involves health assessments, documentation, and translation support. We seek candidates with a high school diploma, health IT experience, and p...

Join Healthfirst as a Field Care Coordinator, conducting essential home visits for members in downstate New York. This bilingual role requires travel to perform assessments, collect documentation, and provide translation support. We seek organized professionals with health IT experience and a val...

Seeking a licensed clinical professional (RN, LCSW, etc.) to join Healthfirst's Clinical Technical Assistance Center. In this US-based role, you will apply adult learning theory to develop educational solutions and build clinical capacity. Leverage 3-5 years of experience to enhance care quality,...

Seeking a licensed and board-certified Physician Peer Reviewer for a vital role in utilization management. You will assess medical necessity, ensure regulatory compliance, and collaborate with clinical teams. This remote U.S. position offers comprehensive benefits, including medical coverage and ...

Seeking a bilingual Spanish/English Care Manager to coordinate behavioral and physical healthcare. This role requires a NYS LCSW/LMSW or RN and involves developing care plans, conducting assessments, and liaising with providers. We offer comprehensive benefits including medical, dental, vision, a...

Lead vendor oversight for dental operations at Healthfirst in New York. Ensure compliance and performance by managing relationships and serving as a key liaison. Requires vendor management experience and a bachelor's degree. Benefits include full medical coverage and 401k.

Join Healthfirst as a Field Care Coordinator in Brooklyn, NY. Conduct essential home visits, perform assessments, and provide bilingual support to members. This field-based role requires a high school diploma, bilingual skills, and proficiency with health IT systems. Enjoy comprehensive benefits ...

Join our team as a Finance Operations Analyst in New York. You will manage claims, capitation, and vendor payments, performing reconciliations and creating reports. The role requires experience with health insurance accounting and proficiency in Microsoft Excel. We offer comprehensive benefits in...

Join Healthfirst as a Field Care Coordinator in Brooklyn, NY. Conduct home visits, perform assessments, and support clinical teams for members in downstate New York. Bilingual skills (English/Mandarin/Cantonese preferred) and field-based healthcare experience are key. Enjoy comprehensive benefits...

Seeking a Board Certified Physician for a vital Peer Reviewer role. You will ensure medical necessity and regulatory compliance for Medicare/Medicaid plans. This remote position offers medical/dental coverage, 401k, and PTO. Apply your clinical and utilization management expertise in a collaborat...

Join our team as a UM Pharmacy Technician, reviewing prior authorization requests for medications under the medical benefit. Utilize your PTCB/NHA certification and prior authorization experience to assess clinical criteria and communicate decisions. This remote US role offers medical/dental/visi...