HealthFirst
Remote Jobs
12 Jobs
The Clinical Specialist is the subject matter expert responsible for all clinical case development and resolution within the Appeals & Grievances unit, managing member complaints, grievances, and appeals pertaining to service authorization or delivery. This involves independently researching issues, interpreting regulations, resolving cases, and preparing detailed documentation for Medical Director Review and external appeal processes.
Provider Data Operations Representative
HealthfirstWe provide no-and low-cost health insurance in NYC, Long Island, Orange, Rockland, Sullivan, and Westchester counties.
Provider Operations Representative processing requests to manage Provider records
The Manager, Clinical Appeals & Grievances leads, operates, and advises a fast-paced team, standardizing processes, communicating performance, and overseeing internal/external production teams for quality and compliance. Duties include managing specialists, providing case research oversight, interpreting regulations, ensuring timely resolution, and driving process improvements.
Infrastructure Operations Engineer – Enterprise Storage, Backups
HealthfirstWe provide no-and low-cost health insurance in NYC, Long Island, Orange, Rockland, Sullivan, and Westchester counties.
Infrastructure Operations Engineer managing cloud solutions for Healthfirst.
Senior Manager, Data Engineering, Provider Analytics
HealthfirstWe provide no-and low-cost health insurance in NYC, Long Island, Orange, Rockland, Sullivan, and Westchester counties.
Senior Manager, Data Engineering improving provider data at Healthfirst
PDO Operations Analyst
HealthfirstWe provide no-and low-cost health insurance in NYC, Long Island, Orange, Rockland, Sullivan, and Westchester counties.
Operations Analyst optimizing provider data operations for Healthfirst
Program Coordinator
HealthfirstWe provide no-and low-cost health insurance in NYC, Long Island, Orange, Rockland, Sullivan, and Westchester counties.
The Program Coordinator supports Healthfirst initiatives related to Member Rewards, conducts outreach, tracks implementation status, communicates findings, and assists in updating materials.
Provider Data Operations Specialist
HealthfirstWe provide no-and low-cost health insurance in NYC, Long Island, Orange, Rockland, Sullivan, and Westchester counties.
Provider Data Operations Specialist enhancing quality and provider engagement for Healthfirst
Enterprise AI Architect
HealthfirstWe provide no-and low-cost health insurance in NYC, Long Island, Orange, Rockland, Sullivan, and Westchester counties.
Enterprise AI Architect leading AI technology integration for health insurance
Enterprise API Architect
HealthfirstWe provide no-and low-cost health insurance in NYC, Long Island, Orange, Rockland, Sullivan, and Westchester counties.
Enterprise API Architect ensuring effective API practices at Healthfirst
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