Dental Assistant Supervisor - $2,000 Signing Bonus! HealthFirst Family Care Center, Inc.Dental Assistant Supervisor - $2,000 Signing Bonus!Fall River, MA$29.65–$33.56 / hourDental Assistant Supervisor & Infection Control Coordinator Summary: Under the general supervision of the Chief Dental Officer and Dental Office Manager, the Dental Assistant Supervisor & Infection Control Coordinator provides direct supervision to all Dental Assistants and Dental Outreach Staff including development of schedules for the assistants. Benefits: $2,000 signing bonus, 3.2 weeks of paid time off (PTO), 3 personal days, and 11.5 paid holidays; employer contributed health, dental, vision, life insurance, long term disability and retirement contributions; voluntary flexible spending accounts and disability/critical illness coverage; and employee discounts, referral program, reimbursable licensing fees, tuition reimbursement, and continuing education credits.
Medical Call Center Rep HealthFirst Family Care Center, Inc.Medical Call Center RepFall River, MA$20.50–$23.50 / hourMedical Call Center Rep Summary: The Medical Call Center Rep position is responsible for answering incoming calls utilizing Health Center policies to solve patient issues and directing calls as needed; verifies patient demographic information; schedules, cancels and reschedules patient appointments; and provides general information about HealthFirst via the telephone, including hours of operation and services provided. Benefits: 3.2 weeks of paid time off (PTO), 3 personal days, and 11.5 paid holidays; employer contributed health, dental, vision, life insurance, long term disability and retirement contributions; voluntary flexible spending accounts and disability/critical illness coverage; and employee discounts, referral program, reimbursable licensing fees, tuition reimbursement, and continuing education credits.
IT Manager HealthFirst Family Care Center, Inc.IT ManagerFall River, MA$94,279.09–$106,698.83 / yearResponsibilities include managing IT support operations and escalations; maintaining hardware, software, telecommunications, and clinical systems; coordinating with internal staff, vendors, and hosted service providers to ensure reliable system availability and issue resolution; supporting cybersecurity, compliance, identity management, and HIPAA-related initiatives; supervising and mentoring IT support staff; managing onboarding/offboarding and user access administration; overseeing IT asset lifecycle management and operational budgeting; supporting Epic and other healthcare applications; developing policies, procedures, and training resources; and recommending cost-effective technology improvements aligned with organizational goals. Benefits: 5.2 weeks of paid time off (PTO), 3 personal days, and 11.5 paid holidays; employer contributed health, dental, vision, life insurance, long term disability and retirement contributions; voluntary flexible spending accounts and disability/critical illness coverage; and employee discounts, referral program, reimbursable licensing fees, tuition reimbursement, and continuing education credits.
WIC Nutritionist HealthFirst Family Care Center, Inc.WIC NutritionistFall River, MA$24–$29 / hourWIC Nutritionist Summary: The WIC Nutritionist is responsible for providing nutrition care to women, infants, and children under the supervision of the Senior Nutritionist; participates in the planning, development, and evaluation of participant counseling, education strategies, and nutrition policies; and acts as an aid in making the WIC Department a synergistic, harmonious and productive entity integrated with other HealthFirst Family Care Center, Inc.'s component functions to fulfill the goals and mission of HealthFirst and to contribute to the overall mission, purpose and objective of HealthFirst health services. Benefits: 3.2 weeks of paid time off (PTO), 3 personal days, and 11.5 paid holidays; employer contributed health, dental, vision, life insurance, long term disability and retirement contributions; voluntary flexible spending accounts and disability/critical illness coverage; and employee discounts, referral program, reimbursable licensing fees, tuition reimbursement, and continuing education credits.
Medical Assistant HealthFirst Family Care Center, Inc.Medical AssistantFall River, MA$21–$25 / hourBenefits: 3.2 weeks of paid time off (PTO), 3 personal days, and 11.5 paid holidays; employer contributed health, dental, vision, life insurance, long term disability and retirement contributions; voluntary flexible spending accounts and disability/critical illness coverage; and employee discounts, referral program, reimbursable licensing fees, tuition reimbursement, and continuing education credits. The Medical Assistant is responsible for obtaining pertinent information and reason for the visit; perform pulse, temperature, blood pressure, height, weight, and BMI on all routine clinic visits; and retrieve labs, hospital records, and tests for the provider.
NewDental Assistant Paid Training HealthFirst Family Care Center, Inc.Dental Assistant Paid TrainingFall River, MAHands-on training days will provide opportunities for observing as well as learning to prepare for dental procedures, maintaining and updating patient charts, and assisting with dentistry techniques. HealthFirst Family Care Center, Inc. is offering a full-time, in person, paid Dental Assistant training program which includes both classroom and clinical training thanks to a workforce pipeline fund.
FNP Resident HealthFirst Family Care Center, Inc.FNP ResidentFall River, MAThrough structured mentorship, specialty rotations in women's health, pediatrics, adult medicine, obesity, Hepatitis C, behavioral health, and addiction medicine that strengthen comprehensive primary care skills, and hands-on clinical experience, residents build the clinical expertise, operational confidence, and professional judgment needed to thrive in a primary care setting. Designed to provide continued support after twelve months to new nurse practitioners as they transition into independent practice, community-based primary care for complex and underserved populations across the lifespan.
Manager, Enrollment & Billing HealthfirstManager, Enrollment & BillingHybrid, NY$81,100–$117,470 / yearThis role is ultimately responsible to ensure the integrity of enrollment and payment data by implementing processes that compare state sources of enrollment information (834, roster, etc.) to our core enrollment and eligibility system to ensure that all enrollment and disenrollment activity is captured accurately and that Healthfirst is appropriately paid by the state and subscribers. The incumbent will be responsible for participating in the development and implementation of operating policies & procedures which may include: enrollment; billing; reconciliation, audits, special projects, and back up support of other lines of business as needed or required.
Senior Manager of Performance Improvement HealthfirstSenior Manager of Performance ImprovementLake Mary, FLIf you have a disability under the Americans with Disability Act or a similar law and want a reasonable accommodation to assist with your job search or application for employment, please contact us by sending an email to careers@Healthfirst.org or calling 212-519-1798 . If you receive a communication from a sender whose domain is not @healthfirst.org, or not one of our recruitment partners, please be aware that those communications are not coming from or authorized by Healthfirst.
AVP, Community Engagement HealthfirstAVP, Community EngagementNew York, NY$168,900–$258,400 / yearDirect a tactical outline for a team of Community Engagement Specialists to ensure a robust strategy to deliver short term and long-term results, i.e. to coordinate citywide enrollment and retention events, marketing sites, presentation forums and other venues, for the Medicare sales units, with Senior Centers, Pharmacies, Food Pantries, NYCHA, Supermarkets, Banks, FQHC, Hospital Owners, Providers, Elected Officials, CBOs and other community partners. Regularly engage key partners, contacts and associates (i.e., Managed Care and Community Outreach Directors, FQHC leaders, key Elected Officials or Staff, Leaders of Chambers of Commerce, and Business Associations, Leaders of key City Agency Partners, Faith-based Leaders).
Director, HR Technology Programs - Hybrid NY HealthfirstDirector, HR Technology Programs - Hybrid NYNew York, NY$154,600–$236,555 / yearReporting to the VP, HR Operations, in partnership with the full HR Leadership Team, this role oversees implementation projects, ensures data integrity, manages vendor/partner relationships, drives adoption of best practices, and leads team development. In partnership with Program Management, IT, and HR Centers of Excellence (COEs), lead HR technology transformation initiatives including new system implementations, feature rollouts, integrations, and process improvements.
Ancillary Network Account Manager HealthfirstAncillary Network Account ManagerHybrid, NY$68,900–$99,620 / yearUnder the direction of the Manager of Ancillary Services, the Ancillary Services Contractor develops and maintains an Ancillary provider network that ensures Healthfirst members have superior access to the highest quality by focusing efforts on lowering claims costs, improving the quality of care, and increasing member and provider network satisfaction. Create contracts in HF contract software and review credentialing documents submitted by Provider/facility via Universal Credentialing Data Source, The Council for Affordable Quality Healthcare (CAQH) or PDF application to ensure that all the required credentials are included and that valid documents for behavioral Providers and facilities are provided.
Product Owner, Corporate Business Technology HealthfirstProduct Owner, Corporate Business TechnologyNew York, NY$116,800–$168,810 / yearEnable delivery of Product Backlog by presenting backlog to team; creating, owning and refining well-formed user stories and artifacts that describe and detail new products, features and services based on feedback from team, creating acceptance criteria with the team, and accepting stories as they’re completed. Create UAT test cases, organize and facilitate UAT testing, track test results, and work with the scrum master and agile team to resolve issues.
Product Owner, PDO HealthfirstProduct Owner, PDONew York, NY$116,800–$168,810 / yearEnable delivery of Product Backlog by presenting backlog to team; creating, owning and refining well-formed user stories and artifacts that describe and detail new products, features and services based on feedback from team, creating acceptance criteria with the team, and accepting stories as they’re completed. Create UAT test cases, organize and facilitate UAT testing, track test results, and work with the scrum master and agile team to resolve issues.
Manager, Medicaid Strategic Initiatives HealthfirstManager, Medicaid Strategic InitiativesHybrid, NY$103,400–$149,430 / yearWorks closely with cross functional teams such as Retention, Enrollment & Billing, Claims, Member Services, Compliance, Sales, Finance, Enterprise Analytics, Marketing, and senior management in implementing new products, product enhancements, business implementations, end to end process improvements, and improvements in the membership experience. The Mgr Medicaid Growth & Retention’s primary focus will be to work cross functionally to develop, execute, support, and continuously improve on strategies and operations related to retention, growth, and financial performance that contribute to profitable growth in the PHSP product portfolio.
Director, Enterprise Delivery Services - Clinical HealthfirstDirector, Enterprise Delivery Services - ClinicalNew York, NY$174,700–$267,155 / yearThe Director is a leader on the Enterprise Delivery Services team and oversees multiple enterprise-wide teams, projects and programs that are broad in scope and independently manages large or mega projects that have enterprise-level strategic importance, high to very high risk and risk interdependencies, multiple interrelationships, and major costs associated with project delivery. Actively facilitates discussions to address issues including risk management within and across associated projects and presents information to key stakeholders including committees, project sponsors and leaders at all levels.
Team Lead Enrollment and Billing HealthfirstTeam Lead Enrollment and BillingLake Mary, FL$68,900–$99,620 / yearIt encompasses the development and implementation of operating policies & procedures which may include enrollment, billing, reconciliation, audits, special projects, and back up support of other lines of business as needed or required. If you have a disability under the Americans with Disability Act or a similar law and want a reasonable accommodation to assist with your job search or application for employment, please contact us by sending an email to careers@Healthfirst.org or calling 212-519-1798 .
Lead Enterprise Process Architect HealthfirstLead Enterprise Process ArchitectNew York, NY$174,700–$267,155 / yearThe Lead Enterprise Process Architect is a member of the Enterprise Architecture team responsible for defining and governing the enterprise process architecture framework that enables effective collaboration between people, AI agents, automation capabilities, and enterprise systems. The role advances process architecture practices for the age of AI, including agentic operating models, process decomposition frameworks, decision architecture, human-in-the-loop design, and enterprise workflow orchestration.
Director Enterprise Delivery Services HealthfirstDirector Enterprise Delivery ServicesNew York, NY$174,700–$267,155 / yearCollaborate with and support across various functional operations owners and across enterprise delivery teams to prioritize and ensure the successful implementation of the defined roadmap and advance key initiatives. Partner across the Enterprise Delivery Services leadership team to identify and highlight conflicts, risks, prioritization needs and interdependencies for leadership evaluation and prioritization.
Director, Enterprise Delivery Services- Digital Provider Collaboration HealthfirstDirector, Enterprise Delivery Services- Digital Provider CollaborationNew York, NY$174,700–$267,155 / yearJob Description The Director is a leader on the Enterprise Delivery Services team and oversees multiple enterprise-wide teams, projects and programs that are broad in scope and independently manages large or mega projects that have enterprise-level strategic importance, high to very high risk and risk interdependencies, multiple interrelationships, and major costs associated with project delivery. Actively facilitates discussions to address issues including risk management within and across associated projects and presents information to key stakeholders including committees, project sponsors and leaders at all levels.
Configuration and Quality Audit Manager | Hybrid NY HealthfirstConfiguration and Quality Audit Manager | Hybrid NYHybrid, NY$103,400–$149,430 / yearManage, coach, and develop analysts responsible for claim configuration audits, payment validation, data analysis, issue documentation, and remediation tracking; assign work, monitor productivity, and ensure timely completion and consistent quality across all audit activities and deliverables; provide technical guidance, peer review, and feedback to ensure findings are well-supported, consistently documented, and appropriately risk rated. The Manager serves as a reimbursement and configuration audit subject matter expert, leads analysts, partners with operational and technical stakeholders, and reports audit results, root causes, financial impact, and corrective action status to leadership.
IT Manager HealthFirst Family Care Center IncIT ManagerFall River, MA$94,279.09–$106,698.83 / yearResponsibilities include managing IT support operations and escalations; maintaining hardware, software, telecommunications, and clinical systems; coordinating with internal staff, vendors, and hosted service providers to ensure reliable system availability and issue resolution; supporting cybersecurity, compliance, identity management, and HIPAA-related initiatives; supervising and mentoring IT support staff; managing onboarding/offboarding and user access administration; overseeing IT asset lifecycle management and operational budgeting; supporting Epic and other healthcare applications; developing policies, procedures, and training resources; and recommending cost-effective technology improvements aligned with organizational goals. Benefits: 5.2 weeks of paid time off (PTO), 3 personal days, and 11.5 paid holidays; employer contributed health, dental, vision, life insurance, long term disability and retirement contributions; voluntary flexible spending accounts and disability/critical illness coverage; and employee discounts, referral program, reimbursable licensing fees, tuition reimbursement, and continuing education credits.
A&G Clinical Specialist HealthfirstA&G Clinical SpecialistMN$83,100–$120,360 / yearPosition Summary: The Appeals & Grievances Clinical Specialist is responsible for receiving, investigating and responding verbally and in writing to member and provider clinical appeals and grievances. If you have a disability under the Americans with Disability Act or a similar law and want a reasonable accommodation to assist with your job search or application for employment, please contact us by sending an email to careers@Healthfirst.org or calling 212-519-1798.
Field Assessment Registered Nurse, Bronx, NY - $10,000 Sign-On Bonus (Spanish) HealthfirstField Assessment Registered Nurse, Bronx, NY - $10,000 Sign-On Bonus (Spanish)Bronx, NY$102,000–$120,000 / yearDuties and Responsibilities: Conducts home assessments (and virtual assessments, as needed) for prospective members and re-assessments of current members using the Uniform Assessment System (UAS); make enrollment and continued eligibility determinations by utilizing clinical expertise and critical thinking skills. Experience working with a frail adult or elderly population with the ability to determine appropriate care plans and services for frail population as well as negotiate initial service plans so that members and families are in agreement.
A&G Clinical Specialist HealthfirstA&G Clinical SpecialistNV$83,100–$120,360 / yearPosition Summary: The Appeals & Grievances Clinical Specialist is responsible for receiving, investigating and responding verbally and in writing to member and provider clinical appeals and grievances. If you have a disability under the Americans with Disability Act or a similar law and want a reasonable accommodation to assist with your job search or application for employment, please contact us by sending an email to careers@Healthfirst.org or calling 212-519-1798.
A&G Clinical Specialist HealthfirstA&G Clinical SpecialistMT$83,100–$120,360 / yearPosition Summary: The Appeals & Grievances Clinical Specialist is responsible for receiving, investigating and responding verbally and in writing to member and provider clinical appeals and grievances. If you have a disability under the Americans with Disability Act or a similar law and want a reasonable accommodation to assist with your job search or application for employment, please contact us by sending an email to careers@Healthfirst.org or calling 212-519-1798.
A&G Clinical Specialist HealthfirstA&G Clinical SpecialistMA$83,100–$120,360 / yearPosition Summary: The Appeals & Grievances Clinical Specialist is responsible for receiving, investigating and responding verbally and in writing to member and provider clinical appeals and grievances. If you have a disability under the Americans with Disability Act or a similar law and want a reasonable accommodation to assist with your job search or application for employment, please contact us by sending an email to careers@Healthfirst.org or calling 212-519-1798.
A&G Clinical Specialist HealthfirstA&G Clinical SpecialistVA$83,100–$120,360 / yearPosition Summary: The Appeals & Grievances Clinical Specialist is responsible for receiving, investigating and responding verbally and in writing to member and provider clinical appeals and grievances. If you have a disability under the Americans with Disability Act or a similar law and want a reasonable accommodation to assist with your job search or application for employment, please contact us by sending an email to careers@Healthfirst.org or calling 212-519-1798.
A&G Clinical Specialist HealthfirstA&G Clinical SpecialistAL$83,100–$120,360 / yearPosition Summary: The Appeals & Grievances Clinical Specialist is responsible for receiving, investigating and responding verbally and in writing to member and provider clinical appeals and grievances. If you have a disability under the Americans with Disability Act or a similar law and want a reasonable accommodation to assist with your job search or application for employment, please contact us by sending an email to careers@Healthfirst.org or calling 212-519-1798.
A&G Clinical Specialist HealthfirstA&G Clinical SpecialistWY$83,100–$120,360 / yearPosition Summary: The Appeals & Grievances Clinical Specialist is responsible for receiving, investigating and responding verbally and in writing to member and provider clinical appeals and grievances. If you have a disability under the Americans with Disability Act or a similar law and want a reasonable accommodation to assist with your job search or application for employment, please contact us by sending an email to careers@Healthfirst.org or calling 212-519-1798.
A&G Clinical Specialist HealthfirstA&G Clinical SpecialistWA$83,100–$120,360 / yearPosition Summary: The Appeals & Grievances Clinical Specialist is responsible for receiving, investigating and responding verbally and in writing to member and provider clinical appeals and grievances. If you have a disability under the Americans with Disability Act or a similar law and want a reasonable accommodation to assist with your job search or application for employment, please contact us by sending an email to careers@Healthfirst.org or calling 212-519-1798.
A&G Clinical Specialist HealthfirstA&G Clinical SpecialistFL$83,100–$120,360 / yearPosition Summary: The Appeals & Grievances Clinical Specialist is responsible for receiving, investigating and responding verbally and in writing to member and provider clinical appeals and grievances. If you have a disability under the Americans with Disability Act or a similar law and want a reasonable accommodation to assist with your job search or application for employment, please contact us by sending an email to careers@Healthfirst.org or calling 212-519-1798.
A&G Clinical Specialist HealthfirstA&G Clinical SpecialistNE$83,100–$120,360 / yearPosition Summary: The Appeals & Grievances Clinical Specialist is responsible for receiving, investigating and responding verbally and in writing to member and provider clinical appeals and grievances. If you have a disability under the Americans with Disability Act or a similar law and want a reasonable accommodation to assist with your job search or application for employment, please contact us by sending an email to careers@Healthfirst.org or calling 212-519-1798.
A&G Clinical Specialist HealthfirstA&G Clinical SpecialistIN$83,100–$120,360 / yearPosition Summary: The Appeals & Grievances Clinical Specialist is responsible for receiving, investigating and responding verbally and in writing to member and provider clinical appeals and grievances. If you have a disability under the Americans with Disability Act or a similar law and want a reasonable accommodation to assist with your job search or application for employment, please contact us by sending an email to careers@Healthfirst.org or calling 212-519-1798.
A&G Clinical Specialist HealthfirstA&G Clinical SpecialistCT$83,100–$120,360 / yearPosition Summary: The Appeals & Grievances Clinical Specialist is responsible for receiving, investigating and responding verbally and in writing to member and provider clinical appeals and grievances. If you have a disability under the Americans with Disability Act or a similar law and want a reasonable accommodation to assist with your job search or application for employment, please contact us by sending an email to careers@Healthfirst.org or calling 212-519-1798.
A&G Clinical Specialist HealthfirstA&G Clinical SpecialistWI$83,100–$120,360 / yearPosition Summary: The Appeals & Grievances Clinical Specialist is responsible for receiving, investigating and responding verbally and in writing to member and provider clinical appeals and grievances. If you have a disability under the Americans with Disability Act or a similar law and want a reasonable accommodation to assist with your job search or application for employment, please contact us by sending an email to careers@Healthfirst.org or calling 212-519-1798.
A&G Clinical Specialist HealthfirstA&G Clinical SpecialistOH$83,100–$120,360 / yearPosition Summary: The Appeals & Grievances Clinical Specialist is responsible for receiving, investigating and responding verbally and in writing to member and provider clinical appeals and grievances. If you have a disability under the Americans with Disability Act or a similar law and want a reasonable accommodation to assist with your job search or application for employment, please contact us by sending an email to careers@Healthfirst.org or calling 212-519-1798.
A&G Clinical Specialist HealthfirstA&G Clinical SpecialistTX$83,100–$120,360 / yearPosition Summary: The Appeals & Grievances Clinical Specialist is responsible for receiving, investigating and responding verbally and in writing to member and provider clinical appeals and grievances. If you have a disability under the Americans with Disability Act or a similar law and want a reasonable accommodation to assist with your job search or application for employment, please contact us by sending an email to careers@Healthfirst.org or calling 212-519-1798.
A&G Clinical Specialist HealthfirstA&G Clinical SpecialistDE$83,100–$120,360 / yearPosition Summary: The Appeals & Grievances Clinical Specialist is responsible for receiving, investigating and responding verbally and in writing to member and provider clinical appeals and grievances. If you have a disability under the Americans with Disability Act or a similar law and want a reasonable accommodation to assist with your job search or application for employment, please contact us by sending an email to careers@Healthfirst.org or calling 212-519-1798.
A&G Clinical Specialist HealthfirstA&G Clinical SpecialistNY$83,100–$120,360 / yearPosition Summary: The Appeals & Grievances Clinical Specialist is responsible for receiving, investigating and responding verbally and in writing to member and provider clinical appeals and grievances. If you have a disability under the Americans with Disability Act or a similar law and want a reasonable accommodation to assist with your job search or application for employment, please contact us by sending an email to careers@Healthfirst.org or calling 212-519-1798.
A&G Clinical Specialist HealthfirstA&G Clinical SpecialistOK$83,100–$120,360 / yearPosition Summary: The Appeals & Grievances Clinical Specialist is responsible for receiving, investigating and responding verbally and in writing to member and provider clinical appeals and grievances. If you have a disability under the Americans with Disability Act or a similar law and want a reasonable accommodation to assist with your job search or application for employment, please contact us by sending an email to careers@Healthfirst.org or calling 212-519-1798.
Executive Assistant, Legal | Hybrid NY HealthfirstExecutive Assistant, Legal | Hybrid NYNY$68,900–$99,620 / yearThe Executive Legal Assistant supports the Chief Legal Officer/General Counsel and provides the Legal Department with administrative help and acts as an internal departmental liaison to all internal and external stakeholders. Controls operational aspects of the department including Right Fax, lien requests, outside counsel invoice tracking, maintenance of the legal library, routing the daily mail, office supplies.
Medical Call Center Rep HealthFirst Family Care Center IncMedical Call Center RepFall River, MA$20.50–$23.50 / hourMedical Call Center Rep Summary: The Medical Call Center Rep position is responsible for answering incoming calls utilizing Health Center policies to solve patient issues and directing calls as needed; verifies patient demographic information; schedules, cancels and reschedules patient appointments; and provides general information about HealthFirst via the telephone, including hours of operation and services provided. Benefits: 3.2 weeks of paid time off (PTO), 3 personal days, and 11.5 paid holidays; employer contributed health, dental, vision, life insurance, long term disability and retirement contributions; voluntary flexible spending accounts and disability/critical illness coverage; and employee discounts, referral program, reimbursable licensing fees, tuition reimbursement, and continuing education credits.
Field Assessment Registered Nurse, Bronx, NY - $10,000 Sign-On Bonus (Spanish) HealthfirstField Assessment Registered Nurse, Bronx, NY - $10,000 Sign-On Bonus (Spanish)NY$102,000–$120,000 / yearDuties and Responsibilities: Conducts home assessments (and virtual assessments, as needed) for prospective members and re-assessments of current members using the Uniform Assessment System (UAS); make enrollment and continued eligibility determinations by utilizing clinical expertise and critical thinking skills. Experience working with a frail adult or elderly population with the ability to determine appropriate care plans and services for frail population as well as negotiate initial service plans so that members and families are in agreement.
Sr. Manager, Pharmacy Benefits HealthfirstSr. Manager, Pharmacy BenefitsNY$122,900–$188,020 / yearDuties & Responsibilities: • Works collaboratively to design and manage the Healthfirst Pharmacy Benefit for all plans • Strategically leads the development, planning and implementation of the annual pharmacy benefit cycle to ensure that pharmacy benefits are in-line with Healthfirst Product Strategy, PBM capabilities and regulatory timeframes • Reviews and facilitates the response and/or the action plan for all applicable CMS memos and other notifications • Collaborates with Pharmacy, Actuary, Finance, Medical Economics and Product teams to analyze and present monthly cost trends for all lines of business • Partners with designated team members to develop, coordinate and manage drug related medical coverage policies • Supports pharmacy leadership efforts to drive improvement of product quality goals • Manages the Benefits team and works with others on the Pharmacy team to oversee administration and monitoring of pharmacy benefit operations along with oversight of the PBM • Performs Utilization Management reviews of relevant drugs when necessary • Assists in regulatory and compliance audits for all designated plans. Minimum Qualifications: • Doctor of Pharmacy (PharmD) from an accredited institution • Licensed Pharmacist in good standing • Knowledge of regulations of the Centers for Medicare and Medicaid Services and the New York State Department of Health • Knowledge of specialty pharmaceuticals and billing practices in the medical and pharmacy benefits • Experience with pharmacy benefit management oversight including maintaining policies and procedures related to formulary design and utilization management processes.
FNP Resident HealthFirst Family Care Center IncFNP ResidentFall River, MAThrough structured mentorship, specialty rotations in women's health, pediatrics, adult medicine, obesity, Hepatitis C, behavioral health, and addiction medicine that strengthen comprehensive primary care skills, and hands-on clinical experience, residents build the clinical expertise, operational confidence, and professional judgment needed to thrive in a primary care setting. Designed to provide continued support after twelve months to new nurse practitioners as they transition into independent practice, community-based primary care for complex and underserved populations across the lifespan.
NewHospital Strategic Account Manager II HealthfirstHospital Strategic Account Manager IINew York, NY$83,100–$120,360 / yearThe Associate of Strategic Account Management is a pivotal role responsible for a wide range of tasks to ensure that each Strategic Account Management team is aligned and delivers results. If you have a disability under the Americans with Disability Act or a similar law and want a reasonable accommodation to assist with your job search or application for employment, please contact us by sending an email to careers@Healthfirst.org or calling 212-519-1798.
Senior HR Process & Service Design Manager | Hybrid NY HealthfirstSenior HR Process & Service Design Manager | Hybrid NYNY$122,900–$188,020 / yearThe Senior HR Process & Service Design Manager partners closely with HR Operations, HR Technology, People Analytics, Total Rewards, and HR Centers of Excellence to translate strategy into clear, executable processes that improve employee experience, reduce demand, and strengthen operational performance. If you have a disability under the Americans with Disability Act or a similar law and want a reasonable accommodation to assist with your job search or application for employment, please contact us by sending an email to careers@Healthfirst.org or calling 212-519-1798.
NewAppeals and Grievances Clinical Specialist/ Quality Of Care HealthfirstAppeals and Grievances Clinical Specialist/ Quality Of CareNY$83,100–$120,360 / yearPosition Summary: The Appeals & Grievances (A&G) unit manages Healthfirst member complaints, grievances and appeals that are presented by the member or provider pertaining to the authorization of or delivery of clinical and non-clinical services. Prepare cases for Medical Director Review ensuring that all pertinent information (i.e. case summary, contract information, internal and external responses, diagnosis, and CPT codes and descriptions) has been obtained during investigation and is presented as part of the case.
Medical Assistant HealthFirst Family Care Center IncMedical AssistantFall River, MA$21–$25 / hourBenefits: 3.2 weeks of paid time off (PTO), 3 personal days, and 11.5 paid holidays; employer contributed health, dental, vision, life insurance, long term disability and retirement contributions; voluntary flexible spending accounts and disability/critical illness coverage; and employee discounts, referral program, reimbursable licensing fees, tuition reimbursement, and continuing education credits. The Medical Assistant is responsible for obtaining pertinent information and reason for the visit; perform pulse, temperature, blood pressure, height, weight, and BMI on all routine clinic visits; and retrieve labs, hospital records, and tests for the provider.