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Sr Data Analyst

NY Req ID: R016560
Provide analytical support to the performance improvement specialist and program managers.              Process mapping for business units.        Provide Blackbelts with prototyping of queries.  Provide queries so that IT can automate the queries.   Create forms for business units using excel...
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Sr Data Engineer

NY Req ID: R020083 Remote
• Test planning and execution• Ensure all strategic projects and operational projects meet the highest quality possible by following industry recognized testing methodologies and best practices.• Provide oversight and overall test execution management of all system and integrated release testing...
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Sr Data Engineer

NY Req ID: R020105 Remote
Designs and implements standardized data management procedures around data staging, data ingestion, data preparation, data provisioning, and data destruction (e.g., scripts, programs, automation, etc.)Ensures quality of technical solutions as data moves across multiple zones and...
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Sr Ent Business Analyst

FL Req ID: R020106 Hybrid
Elicit complex requirements (business, functional, non-functional, and technical) using interviews, document analysis, requirements workshops, surveys, site visits, business process descriptions, use cases, scenarios, task and workflow analysis.Document and maintain requirements by performing...
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Sr Investigator

NY Req ID: R020022 Remote
Conduct Indepth research and review of suspected fraudulent or abusive patterns to develop sufficient evidence to conclusively establish facts involving members, providers or other entities. Collect, utilize and interpret data obtained from a variety of computer generated reports and other...
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Sr Provider Advocate

NY Req ID: R020025 Remote
Duties & Responsibilities:Work within a team of Senior Provider Advocates and dedicated Senior Claims Examiners.Develop and maintain professional and effective relationships with assigned Providers and with associates in key functional areas.Responsible for conducting root cause analysis and...
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Sr Provider Advocate

NY Req ID: R016628 Remote
Duties & Responsibilities: Work within a team of Senior Provider Advocates and dedicated Senior Claims Examiners. Develop and maintain professional and effective relationships with assigned Providers and with associates in key functional areas. Responsible for conducting root cause analysis and...
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Sr Relationship Coord

NY Req ID: R020104 Hybrid
Duties and ResponsibilitiesAdministers new hire training and refresher training to the relationship coordinator team.Creates and keeps all training materials up to date with the latest processes and procedures in an organized SharePoint site.Contributes to the development and implementation of...
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Sr Service Agent

FL Req ID: R020195 Remote
Duties and Responsibilities ·       Provides high quality assistance to the team via phone, chat, video call, email, in person, and/or other communication channels related to servicing our members and/or providers. May include but is not limited to inbound/outbound calls/emails/chats,...
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Sr Service Agent

FL Req ID: R020112 Remote
Duties and Responsibilities ·       Provides high quality assistance to the team via phone, chat, video call, email, in person, and/or other communication channels related to servicing our members and/or providers. May include but is not limited to inbound/outbound calls/emails/chats,...
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Sr Service Agent - CCO

NY Req ID: R020151 Remote
Duties and Responsibilities ·       Provides high quality assistance to the team via phone, chat, video call, email, in person, and/or other communication channels related to servicing our members and/or providers. May include but is not limited to inbound/outbound calls/emails/chats,...
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Sr Service Agent- Remote

NY Req ID: R016515 Remote
Duties and Responsibilities Provides high quality assistance to the team via phone, chat, video call, email, in person, and/or other communication channels related to servicing our members and/or providers. May include but is not limited to inbound/outbound calls/emails/chats,...
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Sr. Claims Examiner

FL Req ID: R020069 Remote
Duties and Responsibilities:Reviewing and investigating claims and encounters for medical, facility, pharmacy, dental and vision services including contractual provisions, authorizations and Healthfirst Policy and Procedure.Subsequent auditing and handling of specific claims and appeal requests...
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Sr. Operations Specialist

FL Req ID: R020073 Remote
Duties/Responsibilities:Functions as the primary point of contact for all delegated and non-delegated entities with regards to onboarding/credentialing providers.Responsible for the resolution of all issues, including those identified by the provider, and those identified internally that impact...
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Sr. Retention Advocate

NY Req ID: R020110 Hybrid
Duties & Responsibilities:Contact member or primary caregiver by phone or letter to arrange a telephonic or in person interview to assess Medicaid/Medicare/Medicare Savings Program eligibility. Ensures all calls are in accordance to approved Healthfirst scriptsHas full and complete access to...
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Sr. Service Agent

NY Req ID: R020121 Remote
Duties and Responsibilities ·       Provides high quality assistance to the team via phone, chat, video call, email, in person, and/or other communication channels related to servicing our members and/or providers. May include but is not limited to inbound/outbound calls/emails/chats,...
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Sr. Service Agent - CCO

FL Req ID: R020157 Remote
Duties and Responsibilities ·       Provides high quality assistance to the team via phone, chat, video call, email, in person, and/or other communication channels related to servicing our members and/or providers. May include but is not limited to inbound/outbound calls/emails/chats,...
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Sr. Strategic Data Analyst

FL Req ID: R016522 Remote
Duties & Responsibilities:  Leverage leading analytical tools to generate insights that facilitate key decisions by department Leadership Develop repeatable analytics aimed at department and Executive Leadership that provide insights into the health and performance of the department. Leverage...
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Sr. Strategic Data Analyst

FL Req ID: R016524 Remote
Duties & Responsibilities:  Leverage leading analytical tools to generate insights that facilitate key decisions by department Leadership Develop repeatable analytics aimed at department and Executive Leadership that provide insights into the health and performance of the department. Leverage...
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