- Healthfirst (NY)
- …+ Work as a senior member of the cloud engineering team + Develop automated capabilities to deliver capabilities more efficiently + Drive solutions to problems ... impacting mission critical systems and implement automation to prevent reoccurrence + Execute changes on production systems + Work in center of excellence for cloud usage and cloud development standards + Work closely with other development and operations team… more
- Healthfirst (FL)
- …etc.) + Ensures quality of technical solutions as data moves across Healthfirst environments + Provides insight into the changing data environment, data processing, ... works with data consumers on updates + Aligns data architecture to Healthfirst solution architecture; contributes to overall solution architecture + Helps maintain… more
- Healthfirst (FL)
- …+ Manage the relationship and resolution of Member inquiries with respect to all Healthfirst vendor partners in concert with or on behalf of the Member(s) + Meet ... medical and departmental information; adhere to local, state, federal and Healthfirst specific compliance and regulatory guidelines + Build sustainable relationships… more
- Healthfirst (NY)
- …+ Contributes to the strategic development of the CE engagements calendar + Responsible for end-to-end event planning and implementation + Tracks Budgets and Vendor ... Management for Events and Conferences + Manage project plans for long term and short-term Initiatives + Directs the event reporting arm of the department: development, track, and report key operational indicators; identify partner and/or service gaps and other… more
- Healthfirst (NY)
- …to business decision logs, data universes, etc. + Partners with key Healthfirst stakeholders such as but not limited to Legal, Regulatory, Compliance, Finance, ... and Pharmacy to identify, understand, and process audit deliverables + Responds to regulatory actions and audit inquiries timely and effectively + Identifies and recommends process improvements to better ensure compliance with regulations + Additional duties… more
- Healthfirst (NY)
- …+ HS Diploma or GED **Preferred Qualifications:** + Bachelors degree + Knowledge of related NY state and federal regulations highly desirable + Proficiency in ... + Prepare cases for the clinical team by gathering documentation, loading evidence, and making calls to members and providers. + Perform administrative activities including but not limited to generating and printing determination and authorization notification… more
- Healthfirst (FL)
- …Aligns Testing Support Services under the Quality Assurance Team for strategic planning as it pertains to organization standards. Builds the testing process and ... policies along with defining technical solutions and tools to support the testing framework. Ensures that standardized QA methods and procedures are used for efficient and prompt handling of all testing activities and automation opportunities. Emphasizes cross… more
- Healthfirst (FL)
- …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 physicians treatment plans and recommends interventions that align with proposed goals. Generates referrals to providers, community-based resources, and appropriate services and other… more
- Healthfirst (FL)
- …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 physicians treatment plans and recommends interventions that align with proposed goals. Generates referrals to providers, community-based resources, and appropriate services and other… more
- Healthfirst (NY)
- **Duties & Responsibilities:** + Works collaboratively to design and manage the Healthfirst Pharmacy Benefits for all Healthfirst plans. + Collaborates with ... and Actuary to analyze, interpret, and manage pharmacy cost trends for all Healthfirst plans + Provides support and/or oversight for all clinical and operational… more