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Field Care Coordinator

CT Req ID: R019982 On-site
Duties/Responsibilities:Schedules and conducts multiple home visits per day (clustered in small geographic areas)Supports the Healthfirst clinical team members, including UAS nurses and Care Managers, by interpreting the employee-to-member and member-to-employee conversation.  Facilitates...
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Field Service Agent

NY Req ID: R016366
Duties/Responsibilities: Provide high-quality customer service to providers and members across all LOBs with a variety of questions and issues on topics such as eligibility, benefits, claims process, escalations, and products Manage face-to-face encounters by interacting with customers to provide...
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Field Service Agent

NY Req ID: R016398 Hybrid
Duties/Responsibilities: Provide high-quality customer service to providers and members across all LOBs with a variety of questions and issues on topics such as eligibility, benefits, claims process, escalations, and products Manage face-to-face encounters by interacting with customers to provide...
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Finance Analyst

CA Req ID: R018738 Hybrid
Responsibilities:Evaluate business processes, anticipating requirements, uncovering areas for improvement, and developing and implementing solutionsLead ongoing reviews of business processes and developing optimization strategiesStaying up-to-date on the latest process and IT advancements to...
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Finance Auditor 2

NY Req ID: R019816 Hybrid
Planning, direction and operation of the financial services of the health plan under the direction of the Chief Executive Officer or Chief Financial Officer. Directing all accounting, financial reporting, and asset control and disbursement functions in addition to coordinating the preparation of...
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Finance Coordinator

MA Req ID: R018730 Hybrid
Duties and Responsibilities:Responsible for financial analysis and reporting of assigned cost centers.  Produce monthly variance reports, vendor analysis and executive summaries to business owners.Responsible for monthly accrual preparation for assigned cost centers. Additionally, making all...
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Financial Data Analyst

NY Req ID: R016558 Hybrid
EMR adjustments: Create new adjustment files for any data that is not flowing through automated processes in data warehouse. These adjustments are also needed to fix any anomaly data in DWH. AX and GL interface: Controlling the data that flows from data warehouse to GL. GL and EMR reconciliation:...
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Fraud Examiner

Req ID: R017103 Remote
Submit standard RFIs for routine reviews, inclusive of requests made to external business partners such as Medicare Broker Field Marketing Offices (FMO); and Ancillary Agencies for member involved and impacted allegations of Theft and or Assault. Perform routine and basic reviews such as the...
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Healthcare Analyst

NY Req ID: R016553 Hybrid
UPDATE Provide support to the Provider Organizations performance improvement work groups. -Monitor costs and revenue trends for Provider Organizations and assist in understanding trends. -Understand and analyze impacts of new program changes. -Responsible for creating, modifying, and updating...
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Healthcare Analyst - TEST BG 2

NY Req ID: R016538 Hybrid
Analyze the financial performance of all Healthfirst products, identify favorable and unfavorable trends, develop recommendations to improve trends, communicate recommendations to management. Create financial models to evaluate the impact of provider reimbursement changes. Gather data and...
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