- Healthfirst (ME)
- …+ Work closely with all levels of end users to quickly document business processes and workflows and begin identifying possible approaches to gaps, issues or risks + ... Gather, analyze and document user requirements + Assist in reporting and presenting requirements and possible approaches to client + Clearly describe project work to both client and Hyphen + Manage multiple priorities simultaneously + Translate business and… more
- Healthfirst (MS)
- …+ Plays a leadership role in the definition and execution of the Information Management roadmap. + Supports Data Architecture roadmap by managing architectural runway ... for enterprise data model, enterprise data store/warehouse, information management, and advanced data analytics capabilities. + Provides data architecture thought leadership to cross-functional teams in the areas of advanced data techniques, including data… more
- Healthfirst (NY)
- …+ Lead a team of technical managers and engineers to build highly scalable solutions + As a leader, you will help develop Hyphens products and mentor other ... engineering managers and team members in the process + You will collaborate with other engineering teams, and work autonomously to maintain existing products and participate in new initiatives + Work with leadership across teams to plan new projects and… more
- Healthfirst (NY)
- …+ Coordinates and manages marketing, educational, and ad hoc material reviews including assisting the Regulatory Affairs Manager by reviewing, finalizing, submitting, ... and tracking approvals of material reviews in HPMS. + Actively participates in the annual Medicare Go to Market process, including working with internal stakeholders on developing significant marketing documents, assigning material IDs, and tracking… more
- Healthfirst (NY)
- …timeliness, accuracy, and consistency. + Coordinates and communicates with Healthfirst Care Management teams regarding clinical eligibility issues, necessary service ... Director in directing, training, and developing team members by embodying the Healthfirst Trailblazer mindset and leading others by example. + Builds and develops… more
- Healthfirst (NY)
- …& Responsibilities** + Develop a vision and strategy that differentiates Healthfirst on our social media channels (LinkedIn, Facebook, Instagram, WeChat, YouTube), ... aligned with the companys brand, reputation and business goals + Define annual objectives for social media channels and measurement plan + Lead content strategy to support key initiatives (eg, marketing acquisition campaigns, community programs, business and… 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 (Enfield, NY)
- …to ensure that departmental productivity goals are met in regards to quality, timeliness, accuracy, and consistency . Allocates, monitors, and assigns resources while ... delegating and monitoring workloads . Implements and supports continuous process improvement and quality initiatives . Provides in-field support to the FCC staff, including supervision, coaching and training . Exercises judgment within defined procedures and… more
- Healthfirst (NY)
- …per week **Duties & Responsibilities:** + Prepare, review, and deliver Healthfirst reporting of financial statements using Statutory Accounting Principles. + Ensure ... all reporting submissions are filed on time, meet the highest standards and are supported by comprehensive documentation. + Perform the GAAP to STAT reconciliation process and Fluctuation comparative analysis including preparing journal entries required. +… more
- Healthfirst (NY)
- …basis every quarter.** **Duties and Responsibilities:** + Monitor experience under Healthfirst 's Medicare line of business + Provide support for annual Medicare ... bids for all Healthfirst 's Medicare products + Review and quantify any regulatory / CMS proposals and/or changes to the Medicare program + Assist in other actuarial… more
- Healthfirst (NJ)
- …Candidate must be able to communicate fluently in Cantonese or Mandarin + Handles calls to and from members to assist with benefit questions/issues, schedule ... appointments, and screen assessments to identify risk factors which need closer intervention. + Handles calls to and from providers regarding authorizations, referrals, visits, tests, and faxed care plans. + Documents accurate member information in compliance… 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 (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)
- …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 (IA)
- …+ Oversees utilization management functions which include timely authorizations related to pre-certification, concurrent review, referrals, and other plan services + ... Develops and monitors goals for staff; provides ongoing feedback and coaching; conducts annual performance reviews; leads by example; and ensures an atmosphere of open communication, teamwork, and ownership and empowerment to make informed decisions +… more
- Healthfirst (NY)
- …or after shift scheduled. + Engage in mastering the Divisions impact on all Healthfirst Plans and its members. + Ability to create a positive impression during first ... call center with telemarketing responsibilities within a healthcare environment. + Healthfirst product knowledge of Complete Care, Senior Health Partners (SHP) or… more
- Healthfirst (NY)
- …**Duties and Responsibilities** **SHP Renewal Line: (Inbound/Outbound)** Handle inbound and outbound calls to and from customers to address their needs while adhering ... to our service level goals. Screen all incoming calls and handles accordingly. Transfer calls to appropriate staff, unit, or department. Assist callers requesting assistance with Medicaid Renewal application, Medicare Savings Program application, and New… 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 (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