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HF Management Services
Lake Mary, FL
The Medicare Enrollment Representative is responsible for the accurate and timely processing of Medicare Enrollment applications. Review application and determine member eligibility using Marx/e-paces/job aides for enrollment purposes. Key enrollment data from actual application into Healthfirst enrollment systems by verifying eligibility from member application. Ad hoc reports and system updates...
HF Management Services
New York, NY
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...
HF Management Services
New York, NY
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...
HF Management Services
New York, NY
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...
HF Management Services
New York City, NY, 10007
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...
HF Management Services
New York City, NY
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...
HF Management Services
New York City, NY
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...
HF Management Services
New York City, NY
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...
HF Management Services
New York, NY
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...
HF Management Services
New York, NY
The Director Clinical Eligibility at Senior Health Partners (SHP) a Managed Long-Term Care Plan (MLTCP), in collaboration with the VP Business Development, will ensure that prospective enrollees are appropriately screened to meet eligibility requirements and a service plan is developed, implemented and communicated with all relevant parties. Incumbent along with the Assistant Director of Clinical...
HF Management Services
NY, NY
Perform audit functions for internal business units and delegated vendors/partners to determine operational efficiency, adherence to regulatory requirements and achievement of quality standards. Frequently communicates information and interacts through electronic documentation/tools. This is a paperless work environment requiring daily hands-on administration of multiple electronic Patient Health...
HF Management Services
New York, NY
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...
HF Management Services
New York, NY
In collaboration with the Director, incumbent is responsible for oversight of the Clinical Intake Nurse Department for HealthFirst. Provides orientation and supervision to Intake Nurses, Auditors and their managers/supervisors. Ensures that all referral receive the consistent and timely nursing visits to determine enrollment. Develops efficient and effective systems that ensure quality care, compl...
HF Management Services
New York, NY
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...
HF Management Services
New York, NY
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...
HF Management Services
Lake Mary, FL
The Provider Services Representative will field inbound calls from providers related to billing and claims. Answer general questions, identify root cause of issues and provide a resolution in line with Healthfirst Policy and Procedures. Escalate issues requiring management intervention, and document all actions within Healthfirst Systems and Applications. Respond to on-line telephone inquiries reg...
HF Management Services
New York, NY
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...
HF Management Services
New York City, NY
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...
HF Management Services
New York City, NY
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...
HF Management Services
New York City, NY
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: 2013.1.5.22-305