Bayonne
HF Management Services Jobs in Bayonne
46 HF Management Services jobs in Bayonne, New Jersey found on Monster.
Reporting to the AVP Clinical Quality, the Manager of Clinical Quality is responsible for leading both clinical and non-clinical staff charged with ensuring that Healthfirst New York PHSP and Medicare members achieve the highest levels of clinical quality, as measured by HEDIS/QARR and STARS. The manager will take an active role in driving quality improvement initiatives in support of HEDIS/QARR a...
Job Title: Ancillary Services Contractor Department: Ancillary Services Reports To: Manager, Ancillary Services Position Summary: Recruit, contract and manage a network of ancillary providers for all lines of Healthfirst's business, in New York and New Jersey. Essential Duties and Responsibilities: · Collect all credentialing documentation related to provider participation. If necessary, conduct c...
Job Title: Delegated Vendor Specialist Department: Ancillary Services Clinical Programs Reports To: Director Ancillary Clinical Programs Position Summary: The Delegated Vendor Specialist will be responsible for assisting the department in the day-to-day management and oversight of Delegated Vendor operations. These tasks include providing direct analytical, technical and account management support...
Job Title: Network Management Representative Department: Provider Relations and Contract Reports To: Field Supervisor Position Summary: The Network Management Representative is Healthfirst's first impression and lead contact for hospitals, physicians and physician groups. This includes developing and nurturing these relationships guaranteeing mutual goals are achieved. Healthfirst is a paperless w...
Job Title: Reimbursement Analyst Department: Claims Reports To: Director, Provider Reimbursement Position Summary: Provide business expertise on reimbursement projects, fee schedule analysis, and accurate payment. Provide technical expertise on data mining, analysis, and creating fee schedule load files. Essential Duties and Responsibilities: · Accurately prepare the rates to be added to the claim...
Job Title: Quality Improvement Auditor Department: PHSP Enrollment Reports To: Senior Manager, Enrollment Operations Position Summary: The Quality Improvement auditor is responsible for measuring application processing accuracy, reviewing the applications, summarizing and analyzing the audit results, and communicating the results to management. Essential Duties and Responsibilities: · Perform mont...
Position supports Medicare lines of business some of which are integrated with State-sponsored programs, such as HMO and HMO SNPs. Incumbent will be responsible for supporting the product management team in the development of benefit analysis, competitive analysis, and CMS required member communications, as well as understand and implement program changes and best practices at Healthfirst. Member...
The Senior Accountant is responsible for the preparation, review and delivery of Healthfirst reporting of financial statements using Statutory Accounting Principles. Assures that all reporting submissions are filed on time, meets the highest standards and is supported by comprehensive documentation. Prepare monthly, quarterly and year-end financial statements and regulatory reports, including foot...
Under supervision of the Human Resources Director, the HR Coordinator performs a variety of administrative HR support functions including but not limited to: tracking employee leaves, gathering required documentation, processing and follow up with Worker's Compensation claims, assisting with communication regarding employee leaves and return to work notifications, termination paperwork etc. Coordi...
This is a field based position for a Reassessment Nurse at Senior Health Partners (SHP) who takes independent ownership for self-scheduling reassessment visits at intervals required by the Department of Health (DOH) to determine service needs and continued eligibility; coordinates with Care Management Team (CMT) to maintain a high level of efficient and effective individualized Care Management ope...
The Entitlement Specialist provides Healthfirst's Medicare Advantage Plan (MAP) and Senior Health Partners' (SHP) Managed Long-Term Care Plan (MLTCP) members and families with assessment and interventions related to obtaining and retaining financial entitlements for which they are eligible. This enables members to maintain the highest level of independence both at home and within their communities...
The Entitlement Specialist provides Healthfirst's Medicare Advantage Plan (MAP) and Senior Health Partners' (SHP) Managed Long-Term Care Plan (MLTCP) members and families with assessment and interventions related to obtaining and retaining financial entitlements for which they are eligible. This enables members to maintain the highest level of independence both at home and within their communities...
Individual will be responsible for the strategy and execution of all copy written in support of Healthfirst's marketing programs. This role includes print advertising, advertorials, medical and care management letters, radio and TV scripts, direct mail, and other materials. Candidate must have excellent writing skills and works with the AVP Creative Services to articulate Healthfirst's position an...
Reporting to the Director Ancillary Clinical Programs, The Delegated Vendor Specialist will be responsible for assisting the department in the day-to-day managementand oversight of Delegated Vendor operations. These tasks include providing direct analytical, technical and account management support as well as identifying, resolving, monitoring, escalating various issues that affect these arrangeme...
Individual will be responsible for the strategy and execution of all copy written in support of Healthfirst's marketing programs. This role includes print advertising, advertorials, medical and care management letters, radio and TV scripts, direct mail, and other materials. Candidate must have excellent writing skills and works with the AVP Creative Services to articulate Healthfirst's position an...
The Copywriter will develop, write and implement a wide variety of member and provider letters, brochures. print materials, broadcast scripts and related collateral that support numerous marketing campaigns throughout the year. The Copywriter must possess the ability to move efficiently and comfortably between multiple projects while ensuring the highest-quality finished product. Write and edit a...
Reporting to the Reassessment Nurse Manager at Senior Health Partners (SHP), the Reassessment Nurse is field based position who takes independent ownership for self-scheduling reassessment visits at intervals required by the Department of Health (DOH) to determine service needs and continued eligibility; coordinates with Care Management Team (CMT) to maintain a high level of efficient and effectiv...
Incumbent ensures that prospective new and active enrollees/members are appropriately screened by assessment staff to meet eligibility requirements. Ensures that an initial and ongoing service plans are developed implemented and communicated with all relevant parties. Incumbent will direct the daily operations of scheduling, staffing needs, clinical coordination. Participates in the training to su...
The Manager, Information Systems (Enterprise Data Management) is required to lead the technical aspects of small and large scale Enterprise Information Management solutions. The Manager, must be able to manage all components of a project from inception to production. The Manager, is responsible for managing the capabilities, contribution, deployment, and performance of technical employees. The tec...
Individual(s) responsible for responding to complaints initiated by regulatory agencies, and oversees the complaint response process to facilitate timely resolutions and responses. Regulatory reporting required. Records all provider and member complaints and inquires initiated by local, state and federal regulatory agencies as well as governmental contracted entities into a company workflow manage...
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©2013 Monster - All Rights Reserved U.S. Patents No. 5,832,497; 7,599,930 B1; 7,827,125 and 7,836,060 MWW - Looking for Monster Cable? - V: 2013.1.5.22-210