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Our Members’ First Line of Support

Healthfirst provides members with quality care. Our Call Center Operations team is the first line of support directly assisting our members. Dafne helps call center representatives stay informed and inspired to provide the best possible member experience. Interested in joining our Operations team? Check out our available positions listed below.

Open Positions in Operations

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CCO Sr Service Agent

NJ Req ID: R018700 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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Claims Implementation Analyst

FL Req ID: R018713 Remote
Duties & ResponsibilitiesAnalyze contract terms, prepare fee schedules and accurately document file changes into the claims processing system Research and identify published updates to payment methodologies, fee schedules and claims editing policies from Medicare, Medicaid, and third-party...
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Claims Supervisor

NY Req ID: R018726 Hybrid
•Responsible for the oversight of claims processing workflow from time of receipt to final adjudication. Review status and inventory reports to ensure acceptable levels are maintained. Alert management to issues affecting timeliness and accuracy of processing and develop plans to...
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Facilities Advisor

NY Req ID: R018729 On-site
Perform light building maintenance such as minor repairs of office furniture and replacement of ceiling tiles.Troubleshooting A/C electrical shorts and flushing out A/C drainage systems with building management.Complete daily work orders such as replacing light bulbs, maintaining proper operation...
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Facilities Manager

CT Req ID: R019822 Hybrid
Oversees the design and construction of all community-based facilities for HFMS and its related entities.Oversees the ongoing maintenance and support of operations at all community based HFMS Facilities.Readily identify issues and problems and determine best practice solutions and implementation...
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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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Manager Contact Center Operations

FL Req ID: R020190 Hybrid
·       Leads and directs teams and functions related to servicing our members and/or providers. May include but is not limited to inbound/outbound calls/emails/chats, onsite/remote/virtual/field location, onshore/offshore, on behalf of CCO. ·       Ensures KPIs including but not limited to...
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Manager, Claims

FL Req ID: R016620 Hybrid
Duties & Responsibilities: The Claims Manager is responsible for assisting examiners with clarification on claims processing. In addition, managing and communicating with both in-house and telecommuting staff. The incumbent is required to work in the office while managing staff that work from...
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Marketing Specialist

NY Req ID: R016012
Manage a broad base of agencies, services and professionals as referral sources. Responsible for scouting new providers and referral sources, while meeting departmental guidelines. Must meet monthly referral goal per department guidelines. This includes: Obtaining weekly designated Licensed Home...
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Mgr Claims Support Group

NY Req ID: R016549 Hybrid
Duties and Responsibilities: Play a key role as Subject Matter Expert (SME) to support internal Operations staff and vendor resources as required. Support the development and operationalizing of departmental initiatives and strategies by working with Operations’ leaders and Project Management to...
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Mgr Claims Support Group

NY Req ID: R020048 Hybrid
Duties and Responsibilities: Play a key role as Subject Matter Expert (SME) to support internal Operations staff and vendor resources as required. Support the development and operationalizing of departmental initiatives and strategies by working with Operations’ leaders and Project Management to...
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Operations Analyst

FL Req ID: R020107 Remote
Duties & Responsibilities: Complete daily, weekly and monthly analysis, reports, summaries and dashboardsReceive and respond to inquiries and complaints and interface with internal and external personnelSupport audit, compliance and regulatory responsibilitiesMeet SLA guidelines in creating...
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Operations Analyst - 100% Remote

NY Req ID: R016442 Remote
Duties & Responsibilities:  Complete daily, weekly and monthly analysis, reports, summaries and dashboards Receive and respond to inquiries and complaints and interface with internal and external personnel Support audit, compliance and regulatory responsibilities Meet SLA guidelines in creating...
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Operations Analyst - 100% Remote

FL Req ID: R016384 Remote
Duties & Responsibilities:  Complete daily, weekly and monthly analysis, reports, summaries and dashboards Receive and respond to inquiries and complaints and interface with internal and external personnel Support audit, compliance and regulatory responsibilities Meet SLA guidelines in creating...
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Per - Care manager-21

Req ID: R016357 Remote
Duties/Responsibilities: Advocates, informs, and educates beneficiaries on services, self-management techniques, and health benefits. Conducts assessments to identify barriers and opportunities for intervention. Develops care plans that align with the physician’s treatment plans and recommends...
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Policy & Process Analyst

NY Req ID: R017197 Remote
Duties & Responsibilities: Writing, formatting, editing, and validating various technical documents. Ensuring all documentation uses standard templates. Interpret Technical Data - Analyzes and interprets technical data to determine relevant material for publication by collaborating with subject...
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QA Kainos - Test Manager

NY Req ID: R020019 Remote
Duties/Responsibilities: Advocates, informs, and educates beneficiaries on services, self-management techniques, and health benefits. Conducts assessments to identify barriers and opportunities for intervention. Develops care plans that align with the physician’s treatment plans and recommends...
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