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US-Telecommuter
Position Summary:   The Behavioral Health Care Manager reviews, evaluates and determines the appropriateness, medical necessity and efficiency of a full continuum of behavioral health treatments and recovery oriented services proposed or provided across all levels of care in accordance with evidenced based practices and consistent with established guidelines and plan benefits to improve health outcomes and effectively manage medical costs. Plans and manages transitions and conducts clinical and service plan reviews for assigned case load in collaboration with the care team.

Healthfirst is an Equal Opportunity Employer and does not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity or expression, veterans, disability status or any other characteristic protected by law.

Requisition ID
2016-13205
Department
Behavioral Health
US-Telecommuter

Healthfirst is a provider-sponsored health insurance company that serves more than 1.2 million members in downstate New York. With more than 4,000 employees, a network of nearly 30,000 providers, and revenues in excess of $8.6 billion, Healthfirst is one of the largest health plans in the New York City area.  

 

Our members are our North Star, and our mission is guided by their needs and preferences in ensuring a superior experience and access to the highest quality healthcare when and where they need it. Healthfirst’s commitment to quality and member satisfaction has helped us earn top ratings for HMO health plans in New York City.

 

We know that employees shape our company and connect us to our communities, and we look to recruit and retain intelligent, driven leaders who are passionate about healthcare and embody our five culture drivers: - Dream Big, Plan Wisely - Break Down the Walls - Think Critically, Speak Up, Deliver with Pride - Inspire Through Trust, Lead By Example - Be Unstoppable

 

Healthfirst is an Equal Opportunity Employer and does not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity or expression, veterans, disability status or any other characteristic protected by law.

Requisition ID
2017-15573
Department
Ops Centralized Services
US-Telecommuter

Healthfirst is a provider-sponsored health insurance company that serves more than 1.2 million members in downstate New York. With more than 4,000 employees, a network of nearly 30,000 providers, and revenues in excess of $8.6 billion, Healthfirst is one of the largest health plans in the New York City area.   Our members are our North Star, and our mission is guided by their needs and preferences in ensuring a superior experience and access to the highest quality healthcare when and where they need it. Healthfirst’s commitment to quality and member satisfaction has helped us earn top ratings for HMO health plans in New York City. We know that employees shape our company and connect us to our communities, and we look to recruit and retain intelligent, driven leaders who are passionate about healthcare and embody our five culture drivers:

- Dream Big, Plan Wisely

- Break Down the Walls

- Think Critically, Speak Up, Deliver with Pride

- Inspire Through Trust, Lead By Example

- Be Unstoppable

 

Healthfirst is an Equal Opportunity Employer and does not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity or expression, veterans, disability status or any other characteristic protected by law.

 

Position Summary:

The Clinical Manager is responsible for supervising virtual Care Management Teams (CMT: Registered Nurses and Social Workers), to coordinate appropriate services and care management to members while ensuring the mission of our program is maintained.

Requisition ID
2017-15425
Department
Care Management - FIDA
US-Telecommuter
Healthfirst is a provider-sponsored health insurance company that serves more than 1.2 million members in downstate New York. With more than 4,000 employees, a network of nearly 30,000 providers, and revenues in excess of $8.6 billion, Healthfirst is one of the largest health plans in the New York City area.   Our members are our North Star, and our mission is guided by their needs and preferences in ensuring a superior experience and access to the highest quality healthcare when and where they need it. Healthfirst’s commitment to quality and member satisfaction has helped us earn top ratings for HMO health plans in New York City. We know that employees shape our company and connect us to our communities, and we look to recruit and retain intelligent, driven leaders who are passionate about healthcare and embody our five culture drivers: - Dream Big, Plan Wisely - Break Down the Walls - Think Critically, Speak Up, Deliver with Pride - Inspire Through Trust, Lead By Example - Be Unstoppable  Position Summary The Clinical Coding Analyst is responsible for performing quality audits that require a clinical evaluation of the medical record documentation to ensure diagnostic codes submitted to State, Federal and other regulatory entities are accurate, appropriately reflect Healthfirst members’ health status and are in accordance with all documentation and coding guidance and requirements.   This position is also responsible for reporting chart review findings based on the auditing methodology and schedules and required to provide general education / relevant feedback as appropriate. The clinical analyst will assist in the interpretation of clinical information, implementation of clinical documentation and improvement activities as well as support departmental HEDIS/QARR initiatives.   This position will report to the Team Lead of Documentation and Coding Audit. Healthfirst is an Equal Opportunity Employer and does not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity or expression, veterans, disability status or any other characteristic protected by law.
Requisition ID
2017-15303
Department
Documentation and Coding

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