- Healthfirst (NY)
- …and departmental information, and adheres to local, state, federal and Healthfirst specific compliance and regulatory guidelines. + Builds sustainable relationships ... of trust through open and interactive communication with internal and external customers. + Works a flexible schedule including a late shift, weekends, and/or holidays (with limited notice at times), and as needed during unforeseen business disruptions. +… more
- Healthfirst (NY)
- …: + Lead in architecting, designing, and configuring solutions with Informatica MDM Multi- Domain edition including Entity 360 and ActiveVOS. + Perform systems/data ... analysis to implement MDM match and merge rules and stored procedures + Applies data analysis, data cleansing, data matching, exception handling, reporting with capabilities of IDQ + Provide technique guidance, mentor, and training for team members + Work with… more
- Healthfirst (MA)
- …your work experience, education, licenses and certifications, and any other factors Healthfirst deems pertinent to the hiring decision. In addition to your salary, ... Healthfirst offers employees a full range of benefits such...401k contributions (all benefits are subject to eligibility requirements). Healthfirst believes in providing a competitive compensation and benefits… more
- Healthfirst (NY)
- …+ Has oversight of the entire broker appointment process to ensure proper completion of contracts and marketing agreements. + Responsible for reviews of credentialing ... paperwork, confirmation of active licenses, and assignment of specific coding to be assigned to all new business for tracking and payment purposes. + Advises the sales and marketing staff regarding producer problems and/or difficulties if outreach/education is… more
- Healthfirst (MT)
- …+ Advocates, informs, and educates beneficiaries on services, self-management techniques, and health benefits. + Conducts assessments to identify barriers and ... opportunities for intervention. + Develops care plans that align with the physicians treatment plans and recommends interventions that align with proposed goals. + Generates referrals to providers, community-based resources, and appropriate services and other… more
- Healthfirst (NY)
- …+ **_Managing day to day operational issues and concerns from hospital partners_** including but not limited to roster maintenance and claim issue root cause analysis ... + **_Managing education/training regarding company-wide initiatives_** including but not limited to new product implementation, regulatory initiatives, and other various health plan business objectives + **_Serving as an advocate for Hospital Providers within… more
- Healthfirst (NY)
- …Conducts home assessments (and virtual assessments, as needed) for prospective members and re-assessments of current members using the Uniform Assessment System ... (UAS); make enrollment and continued eligibility determinations by utilizing clinical expertise and critical thinking skills. As needed, conducts assessments in settings other than home as needed, eg skilled nursing facilities or virtually Navigates multiple… more
- Healthfirst (NY)
- …of technical components within existing frameworks and methodologies required by Healthfirst . + Works across multiple departments in the development of business ... requirements and associated artifacts by developing a deep understanding of business needs, and by collaborating closely with peers, leaders, and staff throughout Operations to ensure the appropriate parties are contributing. + Works with team members to… more
- Healthfirst (NY)
- …+ Oversee the enrollment process, ensuring timely and accurate processing of new and modified enrollments, renewals, and terminations. + Collaborate with internal ... teams (eg, sales, customer service, compliance) to ensure seamless management of members. + Monitor ,report, and deliver updates on memberships, data integrity and address discrepancies related to member eligibility and enrollment. + Manage premium billing… more
- Healthfirst (FL)
- …+ Ensure timely and accurate case documentation in accordance with Healthfirst policies, regulatory requirements, and audit standards. + Participate in department ... meetings, quality audits, training sessions, in-person quarterly town halls and performance reviews as needed. + Meet department metrics for production and quality. **Minimum Qualifications** + HS Diploma or GED from an accredited institution. + Understanding… more
- Healthfirst (FL)
- …+ Designs and implements standardized data management procedures around data staging, data ingestion, data preparation, data provisioning, and data destruction (eg, ... scripts, programs, automation, etc.) + Ensures quality of technical solutions as data moves across multiple zones and environments + Provides insight into the changing data environment, data processing, data storage and utilization requirements for the… more
- Healthfirst (NY)
- …+ Manages designated caseload of members who could benefit from Peer Support services, care coordination, and health navigation + Schedules and conducts multiple ... field-based visits per day (clustered by geographic areas) + Completes assessments and questionnaires to identify barriers and opportunities for intervention + Works telephonically when not in the field to make outreach calls and receive incoming calls to/from… more
- Healthfirst (VA)
- …+ Develop and sustain SailPoint IdentityIQ and SailPoint IdentityNow (ISC) integrations with multiple applications including Active Directory, JDBC, Webservice, SCIM, ... Logical, Workday, ServiceNow, and Flat File. + Oversee and create the approval frameworks and implement the Joiner, Mover, Leaver, and Rehire events in both SailPoint IdentityIQ and SailPoint IdentityNow (ISC). + Implement user provisioning, Custom Workflows… more
- Healthfirst (PA)
- …+ Conduct outreaches for newly enrolled members to review current and approved services, durable medical equipment (DME) and additional requests + Review intake ... documents for pre-approved services and escalate discrepancies as needed + Complete Welcome Onboarding and Consumer Directed Personal Assistant Assessments and identify any issues or risk factors that require clinical escalations to a CM/PCM. + Initiate and… more
- Healthfirst (NY)
- …+ Under the guidance of the Director of Communications at Healthfirst , identify media opportunities, develop pitches, and proactively secure earned media ... coverage that supports Healthfirsts brand and business priorities. + Collaborate with Social Media team to execute engagement growth strategy, including monitoring trends, responding to inquiries, and amplifying Healthfirsts voice across social platforms. +… more
- Healthfirst (FL)
- …+ Customer Service Respond to employee inquiries through inbox, phone and email on all HR topics (performance management, time entry, handle verifications of ... employment, unemployment & documentation inquiries. Assist with employee issues and determine root cause to develop improved process. + Team Support Support on basic benefits, compensation, talent acquisition and talent management administrative activities,… more
- Healthfirst (FL)
- …Facilitate anddeliverlearningeventstosupport theenterpriseinclusive of all business units. Serve as subject matter expert (SME) in thedesign and development ... oflearning contentpartnering with business leaders and the instructional design group. Assist with maintaining and updating all learning content materials, ensuring they meet state, federal or organizational criteria. Partner and consult with internal… more
- Healthfirst (NY)
- …long-term care plan) + Knowledge or prior experience using ePACES and/or CMS-MARx + Healthfirst product knowledge of MLTC and MAP Plans WE ARE AN EQUAL OPPORTUNITY ... EMPLOYER. Applicants and employees are considered for positions and are evaluated without regard to mental or physical disability, race, color, religion, gender, gender identity, sexual orientation, national origin, age, genetic information, military or… more
- Healthfirst (FL)
- …+ Maintain procedures and programs to ensure Operational units meet organizational and regulatory standards for proper function, quality, and in support of enhancing ... Member/Provider service experiences. + Experience applying critical thinking skills and problem-solving approaches in producing analyzing and interpreting reports on trending audit finding results and summarizing details to Operations leadership to address… more
- Healthfirst (Enfield, NY)
- …home visits per day (clustered in small geographic areas) + Supports the Healthfirst clinical team members, including UAS nurses and Care Managers, by facilitating ... needed, escalates member questions, as directed + Properly documents findings in Healthfirst information systems + Collaborates with other members of the clinical… more