Healthfirst Jobs

Excitingly, this position is eligible for remote work. This means you have the flexibility to work from the comfort of your home while being part of our dynamic team. We... Read More

Prepare cases for the clinical team by gathering documentation, loading evidence, and making calls to members and providers. Perform administrative activities including... Read More

Excitingly, this position is eligible for remote work. This means you have the flexibility to work from the comfort of your home while being part of our dynamic team. We... Read More

Duties Responsibilities: Works collaboratively to design and manage the Healthfirst Pharmacy Benefits for all Healthfirst plans. Collaborates with Finance and Actuary to... Read More

Duties and Responsibilities Business lead for external and internal regulatory reporting, surveys, audits, and investigations impacting dental operations In partnership... Read More

Organizes and leads the project team through the entire project life cycle Serves as the main point of contact for all the enabling tools and technology (software and... Read More

Excitingly, this position is eligible for remote work. This means you have the flexibility to work from the comfort of your home while being part of our dynamic team. We... Read More

Duties/Responsibilities: Advocates, informs, and educates beneficiaries on services, self-management techniques, and health benefits. Conducts assessments to identify... Read More

Duties and Responsibilities Responsible for case development and resolution of clinical cases, such as: Pre-existing Conditions, Prior Approval, Medical Necessity,... Read More

Duties/Responsibilities: Adhere to standards of care for children including but not limited to developmentally disabled, medically fragile and foster care populations... Read More

Duties and Responsibilities Conduct outreaches for newly enrolled members to review current and approved services, durable medical equipment (DME) and additional requests... Read More

Excitingly, this position is eligible for remote work. This means you have the flexibility to work from the comfort of your home while being part of our dynamic team. We... Read More

Duties and Responsibilities: Work as a senior member of the cloud engineering team Develop automated capabilities to deliver capabilities more efficiently Drive solutions... Read More

Duties and Responsibilities: Work as a senior member of the cloud engineering team Develop automated capabilities to deliver capabilities more efficiently Drive solutions... Read More

Duties/Responsibilities: Schedules and conducts multiple home visits per day (clustered in small geographic areas) Supports the Healthfirst clinical team members,... Read More

Duties/Responsibilities: Schedules and conducts multiple home visits per day (clustered in small geographic areas) Supports the Healthfirst clinical team members,... Read More

Duties/Responsibilities: Advocates, informs, and educates beneficiaries on services, self-management techniques, and health benefits. Conducts assessments to identify... Read More

Duties and Responsibilities Conduct outreaches for newly enrolled members to review current and approved services, durable medical equipment (DME) and additional requests... Read More

Duties Responsibilities: Review prior authorization requests and units for medications requested under the medical benefit Assess provider-submitted clinical information... Read More