The Scrum Master manages small to large enterprise-level programs that have department or enterprise-level importance, moderate to high risk and risk interdependencies, several interrelationships, and moderate to high costs associated with delivery. The Scrum Master supports programs of major complexity as part of a program team in support of higher-level program or program managers. This position requires three days per week in office (Tues/Wed/...
The Manager, Vendor Performance is responsible for the direct and/or indirect management of all Healthfirst onshore and offshore delegated vendors. The team led by this manager is responsible for the successful onboarding, relationship management, and monitoring of delegated vendor performance by assuring adherence with Key Performance Indicators (KPIs), Service Level Agreements (SLAs), vendor compliance, and regulatory requirements. Work Schedul...
The Manager, Claims Modernization Reporting and Analytics is responsible for the successful implementation of strategic initiatives as a part of a large team of Business, Data and Project Analysts. This individual will be responsible for partnering with their team in support of process improvement initiatives, development of a reporting and analytics program, as well as in-area and corporate projects. This position will have responsibility for co...
As a valuable member of the Healthfirst Care Management team, the Field Care Coordinator (FCC) is responsible for conducting local home visits for Healthfirst members. During these care management visits, the FCC may perform a home environment assessment, administer health questionnaires, retrieve necessary documentation, and/or facilitate a video visit with a Healthfirst Care Manager or Clinical Eligibility Nurse to conduct other required assess...
WE ARE AN EQUAL OPPORTUNITY EMPLOYER. HF Management Services, LLC complies with all applicable laws and regulations. Applicants and employees are considered for positions and are evaluated without regard to race, color, creed, religion, sex, national origin, sexual orientation, pregnancy, age, disability, genetic information, domestic violence victim status, gender and/or gender identity or expression, military status, veteran status, citizenship...
As a valuable member of the Healthfirst Care Management team, the Field Care Coordinator (FCC) is responsible for conducting local home visits for Healthfirst members. During these care management visits, the FCC may perform a home environment assessment, administer health questionnaires, retrieve necessary documentation, and/or facilitate a video visit with a Healthfirst Care Manager or Clinical Eligibility Nurse to conduct other required assess...
As a valuable member of the Healthfirst Care Management team, the Field Care Coordinator (FCC) is responsible for conducting local home visits for Healthfirst members. During these care management visits, the FCC may perform a home environment assessment, administer health questionnaires, retrieve necessary documentation, and/or facilitate a video visit with a Healthfirst Care Manager or Clinical Eligibility Nurse to conduct other required assess...
WE ARE AN EQUAL OPPORTUNITY EMPLOYER. HF Management Services, LLC complies with all applicable laws and regulations. Applicants and employees are considered for positions and are evaluated without regard to race, color, creed, religion, sex, national origin, sexual orientation, pregnancy, age, disability, genetic information, domestic violence victim status, gender and/or gender identity or expression, military status, veteran status, citizenship...
The Director of Utilization Management is a strategic clinical operations leader responsible for delivering operational oversight for Utilization Management (UM) teams. This high-impact leader ensures the delivery of medically necessary, cost-effective, and high-quality care through evidence-based UM processes that fully comply with CMS, NYSDOH, and contractual requirements. The Director drives clinical and operational excellence across the team ...
As a valuable member of the Healthfirst Care Management team, the Field Care Coordinator (FCC) is responsible for conducting local home visits for Healthfirst members. During these care management visits, the FCC may perform a home environment assessment, administer health questionnaires, retrieve necessary documentation, and/or facilitate a video visit with a Healthfirst Care Manager or Clinical Eligibility Nurse to conduct other required assess...
The Sr Retention Advocate is responsible to educate and provide Healthfirst members support in obtaining financial entitlements for which they are eligible. This enables members to maintain the highest level of independence both at home and within their communities. Education within Medicare, the Medicare Savings Program (MSP), assist our members in applying and continuous follow up to eligibility. S/he will be responsible for a longer cycle of w...
The Field Service Agent acts as an in-person liaison between Healthfirst and its customers. This individual receives and addresses member & provider inquiries, de-escalates and resolves complaints, educates clients, engages in member retention activities, and escalates issues requiring additional intervention across all Lines of Business (LOBs) within a face-to-face, telephonic, and/or Omni-channel contact center environment. The Field Service Ag...
