- Healthfirst (TX)
- …+ 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 (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 (Queens, 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 (FL)
- …Strong understanding of application development and engineering principles, sound knowledge of agile methodology (preferably SAFE), good knowledge on database ... concepts, experience in building DevOps pipelines, sound knowledge on quality assurance, excellent leadership and communication skills. Work continuously on identifying new tools and frameworks to improve efficiency & quality. Execute proof of concepts on new… 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
- Healthfirst (NY)
- …made. + Remain current on reporting and database technologies and ensure Healthfirst is leveraging existing systems to maximize optimal value. + Collaborate with ... Information Technology, Business Transformation and Operations teams to support effective department management including introducing new technology, system upgrades and reporting impacts and providing leadership dashboards to assist with managing our… more
- Healthfirst (NY)
- …and accurate reporting of HQIP outcomes to internal staff and external Healthfirst providers. + Develops and delivers presentations for varying levels of staff ... buy-in on strategy or operational decisions + Designs and executes the Healthfirst Quality Incentive Program (HQIP) and other quality incentive programs. +… more
- Healthfirst (NY)
- …+ Bachelors degree from an accredited institution. + At least 5 years previous work experience within risk adjustment + Credentialed Associate of the Society of ... Actuaries (ASA) + Proficiency in SQL (Script Development, Joins) using PostgreSQL, MS SQL Server, MySQL and Advanced MS Excel Skills (Pivot Table Creation, Complex formula development). + Data Visualization Experience (Tableau or Qlik View or, Power BI). +… more
- Healthfirst (Enfield, NY)
- …it. Sales Support has the primary responsibility of connecting Healthfirst with community-based organizations, community health centers, NYCHA, community providers, ... faith-based organizations, community boards, and city agencies. Develop twenty (20) events and/or opportunities per months for the sales representatives which they support. Establish new relationships and maintain existing ones. Support the Sales and Marketing… more
- Healthfirst (Enfield, NY)
- …updates when needed. + Strictly adhere to all CMS regulations and Healthfirst marketing guidelines. + Ensure all documentation is complete, comprehensive, clear, ... appropriately filled out including Application, Application Confirmation Form, Scope of Appointment and Application Submission Form, and Salesforce. + Provide competitive intelligence to management on any activities Healthfirsts market competitors are engaging… more
- Healthfirst (NY)
- …steps related to complex government regulations. + Collaborate with the Healthfirst Compliance department, oversees the implementation and effectuation of all plans ... requirements are met. + Be responsible for bringing pertinent items to Healthfirst Regulatory Change Management and seeing projects through to fruition to ensure… more
- Healthfirst (NY)
- …: + Architect and Design the Data Lakehouse: Lead the design and implementation of a scalable and secure Data Lakehouse on AWS, including data storage and compute ... layers. + Storage Solutions: Design and implement storage solutions using AWS services like S3, Iceberg, + Integrate relevant metadata from platform with data catalog and/or metadata management solutions. + Compute Resources: Architect and optimize compute… more
- Healthfirst (NY)
- …+ Serve as a trusted resource and subject matter expert (SME) in compensation programs, policies, and relevant compensation legislation. + Collaborate closely with ... the Head of Compensation and other members of the Total Rewards team to support day-to-day work and ad-hoc analysis as needed. + Under general direction, collaborate with HR Business Partners (HRBPs) and Talent Acquisition to craft competitive compensation… more
- Healthfirst (FL)
- …+ 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 (NY)
- …+ Leverage leading analytical tools to generate insights that facilitate key decisions by department leadership + Create accurate reports or insightful and ... user-friendly dashboards that meet stakeholders needs and lead to business insights + Identify and monitor cost and utilization trends and the root causes in health plan trend performance, providing recommendations for solutions + Utilize statistical tools to… more