HealthFirst

The Relationship Coordinator handles inbound and outbound calls to educate prospective enrollees about Long-Term Care services and ensures effective communication throughout the enrollment process. This role also involves documenting calls, scheduling appointments, and achieving sales performance goals. | Candidates must have a high school diploma or GED and fluency in English and Spanish. Experience in customer service and the ability to work in a fast-paced environment are essential. | The Relationship Coordinator solicits and provides information via telephonic efforts in support of Healthfirst Medicare Advantage Plan, Complete Care (MAP), Managed Long Term Care Plan (MLTC) Senior Health Partners (SHP) and Mainstream/Health and Recovery Plan (HARP) population seeking PCA and/or CDPAS services. This position ensures that referral sources, prospective enrollees and/or family members are courteously, appropriately, and effectively educated on the Long-Term Care enrollment processed through communication and follow-up and clearly articulate each product line to prospective clients. In addition, the Relationship Coordinator understands how Healthfirst goals relate to sales performance and meet established quotas. Integrated Products is a paperless, call center work environment requiring daily hands-on administration of multiple electronic Patient Health Information (PHI) databases and security requirement tools such as encryption. These systems include, but are not limited to, Salesforce, RightFax, Virtual Work Platforms (using VPN), SharePoint Sites, TruCare and MS Office 365 software (such as Word and Outlook). Duties and Responsibilities Handling inbound and outbound calls to and from customers to address their needs while adhering to internal Service Levels standards. Creates and/or follow ups for up to 90 days on Long-Term Care (LTC) Leads and Opportunities entered in Salesforce. Create and/or follow ups for up to 30 days on Personal Care services requests for the Mainstream population in Salesforce. Answer all calls or complete outbound calls according to approved scripts. Searches ePACEs for Medicaid eligibility, exclusion, and exemption codes. Searches in Marx (CMS) for Medicare eligibility, enrollments, and special elections. Achieves daily, weekly, and monthly growth goals. Handle all calls to maximize productivity and optimal operational efficiency. Connects consumers seeking personal care/long term care services with the State broker to complete the initial evaluation. Schedules all field and tele video conference appointments for SHP Intake Nurses in Salesforce. Schedules all field and tele video conference appointments for HF CompleteCare Specialist and Intake Nurses in Salesforce. Schedules Entitlement Advocates appointments for SHP and HF Complete Care prospective members with a Medicaid coverage issue or restriction. Schedules Clinical Assessors to complete Community Health Assessments for Mainstream/HARP members requesting Personal Care Services at home. Documents all incoming/outbound calls under call tracking in Salesforce Documents all outcomes in pre-enrollment database system. Documents all special instructions in Salesforce Coordinates the preparation of fulfillment kits / brochures to prospective members or those requesting addition information in a timely manner. Troubleshoots and follows up on LTC enrollment rejections. Handles other duties as assigned with the occasional need to work weekends, additional hours before or after shift scheduled. Engage in mastering the Divisions impact on all Healthfirst Plans and its members. Ability to create a positive impression during first contact with prospective members by setting the tone and being able to immediately demonstrate product knowledge and credibility with the goal of maximizing the number of scheduled appointments to achieve daily, weekly, and monthly goals. Persuasive and able to establish trust. Additional duties as assigned. Minimum Qualifications High school diploma or GED. Fluency in reading and speaking English and additional language. Member / Customer Service experience. Availability to work for 8 ½ hours shift, based on business needs, within our hours of operations: Monday – Friday 8:00 AM – 8:00 PM and Saturdays 10:00 AM – 6:30 PM. 8:00 AM to 8:00 PM Monday -Sunday during open enrollment (October – March). Initial Training schedule may vary from permanent assigned schedule. Occasional overtime. Capability to work in a remote environment with reliable internet connection. Tech Savvy computer skills such as Microsoft Office Suites: Outlook, Excel, Word, PowerPoint Organized and multi-tasking capabilities and detail oriented. Understanding of and sensitivity to cultural differences and needs of the community are essential. Adept at working in an environment with fast-past changing priorities including high stress while achieving quota expectations. Available to communicate / engage with your leaders via Virtual platforms (emails, MS Teams and others) Preferred Qualifications Work experience within the healthcare industry Experience with Medicare or Medicaid managed care plan products such as, Family Health Plus (FHP), Eastern Benefits System (EBS) and/or Federal Employee Program (FEP). (Preferred) Associate degree or higher from an accredited institution. Extensive work experience including inbound and outbound call center with telemarketing responsibilities within a healthcare environment. Healthfirst product knowledge of Complete Care, Senior Health Partners (SHP) or managed long-term care. Prior experience engaging / communicating with the frail adult or elderly population. A solid understanding of the value of integrated care. Experience in health insurance, home care environment, acute, sub-acute, long-term care (LTC) setting or managed-long term care (MLTCP). Experience managing member information or appointments in a shared network environment using paperless database modules. Adept at operating within a multi-cultural work environment and community of Members such as Spanish, Chinese, Southeast Asian and others. Ability to maintain a calm, neutral disposition while managing many details in a distracting environment License/Certification: N/A WE ARE AN EQUAL OPPORTUNITY EMPLOYER. HF Management Services, LLC complies with all applicable laws and regulations. Applicants and employees are considered for positions and are evaluated without regard to race, color, creed, religion, sex, national origin, sexual orientation, pregnancy, age, disability, genetic information, domestic violence victim status, gender and/or gender identity or expression, military status, veteran status, citizenship or immigration status, height and weight, familial status, marital status, or unemployment status, as well as any other legally protected basis. HF Management Services, LLC shall not discriminate against any disabled employee or applicant in regard to any position for which the employee or applicant is otherwise qualified. 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 . In your email please include a description of the accommodation you are requesting and a description of the position for which you are applying. Only reasonable accommodation requests related to applying for a position within HF Management Services, LLC will be reviewed at the e-mail address and phone number supplied. Thank you for considering a career with HF Management Services, LLC. Know Your Rights All hiring and recruitment at Healthfirst is transacted with a valid “@healthfirst.org” email address only or from a recruitment firm representing our Company. Any recruitment firm representing Healthfirst will readily provide you with the name and contact information of the recruiting professional representing the opportunity you are inquiring about. 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. Healthfirst will never ask you for money during the recruitment or onboarding process. Hiring Range*: Greater New York City Area (NY, NJ, CT residents): $47,403 - $64,338 All Other Locations (within approved locations): $41,101 - $60,320 As a candidate for this position, your salary and related elements of compensation will be contingent upon your work experience, education, licenses and certifications, and any other factors Healthfirst deems pertinent to the hiring decision. In addition to your salary, Healthfirst offers employees a full range of benefits such as, medical, dental and vision coverage, incentive and recognition programs, life insurance, and 401k contributions (all benefits are subject to eligibility requirements). Healthfirst believes in providing a competitive compensation and benefits package wherever its employees work and live. *The hiring range is defined as the lowest and highest salaries that Healthfirst in “good faith” would pay to a new hire, or for a job promotion, or transfer into this role. Healthfirst is New York’s largest not-for-profit health insurer offering it’s nearly 1.7 million members access to high-quality, affordable healthcare. As part of the community for nearly 30 years, Healthfirst’s unique advantage is rooted in its belief that good health doesn’t start in a doctor’s office. The company’s mission is to put its members first by working closely with care providers and community leaders to address broader issues that can impact health and well-being. This value-based care model is the foundation of the company’s sustained growth in one of the most dynamic markets in the country. So, if you are passionate about what you do and want to work for a company that is focused on the future and dedicated to making a difference in people’s lives, then Healthfirst is for you. Click here to navigate back to the career site!

Lead HR technology and analytics strategy, manage vendor relationships, drive innovation using AI, and lead teams to enhance employee experience and business outcomes. | 10+ years HR operations or technology leadership, expertise in HR tech platforms and analytics, strong stakeholder and change management skills, ability to work onsite 3 days/week. | The Director, HR Technology and Analytics is a strategic leader responsible for shaping how HR data, technology, and analytics drive enterprise decision-making, operational efficiency, and stronger business outcomes. Reporting to the VP, HR Operations, in partnership with the full HR Leadership Team, this role leads the strategy, design, and execution of HR technology and analytics solutions that enhance and analyze the employee experience. Key Responsibilities Technology Transformation & Operations • * 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. • Ensure employee experience remains at the forefront of all technology changes. • Manage vendor relationships, including service level agreements (SLAs), while partnering with IT as Product Owner to resolve emerging issues and execute PI planning. Provide strategic leadership & innovation • * Leverage AI, emerging HR technologies, and people analytics to drive innovation, continuous process improvement, and operational insights • Demonstrate a forward-thinking, innovative mindset and provide strategic insights into how we can best use technology and analytics to execute upon enterprise and HR strategies with measurable outcomes. • Foster a culture of innovation, ensuring prioritization of high-impact work and effective capacity planning. Relationship management • * Manage key stakeholder relationships, ensuring analytics and technology strategies align with business needs. • Partner with members of the HR team and functional leaders to define analyses needed to gain insights into priority business issues. • Partner with OD to determine how to operationalize critical HR and Employee Experience metrics, then define the analyses needed to enhance the employee experience and other HR-related business metrics. • Build strong partnerships across IT and Enterprise Analytics to optimize systems integrations, functionality, data architecture, governance, and employee experience. Ensure enterprise alignment around all AI use cases for HR. Leadership of technology and people analytics teams • * Lead, mentor, and develop the HR Technology and People Analytics team, fostering expertise in analytics, systems, and storytelling. • Guide the people analytics team to conduct analyses, and provide simple, visually compelling stories about the data which provides stakeholders with the insights they need to translate results into actions that impact the business. • Build data literacy and capabilities across HR by developing and deploying an HR data playbook. Qualifications • Ability to be in office at 100 Church Street three days per week (T//W//TH) • 10+ years of progressive HR operations, HR technology, or analytics leadership experience. • Proven expertise in HR technology platforms, people analytics, and leveraging AI for HR innovation. • Strong background in data governance, systems integration, and technology transformation. • Strong facilitation, consulting, and influence skills across a variety of audiences. • Exceptional stakeholder management skills with the ability to translate complex data into insights. • Demonstrated success leading high-performing teams and building organizational capability in data literacy. • Excellent communication, storytelling, and change leadership skills. Preferred Qualifications • Advanced degree in related field Hiring Range*: • Greater New York City Area (NY, NJ, CT residents): $150,800 - $230,690 • All Other Locations (within approved locations): $124,400 - $190,315 As a candidate for this position, your salary and related elements of compensation will be contingent upon your work experience, education, licenses and certifications, and any other factors Healthfirst deems pertinent to the hiring decision. In addition to your salary, Healthfirst offers employees a full range of benefits such as, medical, dental and vision coverage, incentive and recognition programs, life insurance, and 401k contributions (all benefits are subject to eligibility requirements). Healthfirst believes in providing a competitive compensation and benefits package wherever its employees work and live. • The hiring range is defined as the lowest and highest salaries that Healthfirst in “good faith” would pay to a new hire, or for a job promotion, or transfer into this role. 124400-190315

The Program Coordinator is responsible for supporting Healthfirst initiatives related to Member Rewards and Incentives, HEDIS Quality Improvement, Medicare Stars, and Member Satisfaction. This includes verifying reward requests, conducting outreach, and collaborating with teams to track program requirements. | A High School diploma or GED is required, with basic knowledge of MS Office applications. Strong organizational and communication skills are essential, along with the ability to manage responsibilities in a fast-paced environment. | Job Profile Summary The Program Coordinator, Reward Card Program in Clinical Quality is responsible for supporting Healthfirst initiatives and regulatory requirements related to Member Rewards and Incentives, HEDIS Quality Improvement, Medicare Stars and Member Satisfaction. This position is both internal (EDS, Marketing, etc.) and external (Members, Provider, Vendor) facing. Duties & Responsibilities: Verifies reward requests based on required preventive services appropriate for the member’s age, gender and other accepted demographics as outlined via the Member Reward Card Program Guidelines, HEDIS/QARR Technical Specifications, and CMS/DOH guidelines Conducts member and provider outreach to inform on reward guidance and status using multiple internal systems and applications Collaborates with internal and external teams to track and document program requirements and implementation status Documents, communicates and presents technical improvement findings and recommendations in all systems supporting Member Rewards Program Provides support in creating, editing and communicating member and provider material updates Additional duties as necessary Minimum Qualifications: High School/GED Diploma from an accredited institution Basic knowledge of MS Word, Excel, Access, and Outlook Strong organizational skills Good communication (verbal and written) and interpersonal skills Flexibility, reliability, and easily adaptable to any work assignments or new computer applications Competent in managing responsibilities in a high-volume and fast-paced environment Ability to resolve member issues with patience and courtesy Preferred Qualifications: Associate’s degree from an accredited institution + 2 Years Work Experience. Experience processing reward card requests highly preferred. Bilingual in English and one or more language(s): Spanish, Mandarin, Cantonese may be required based on business needs Familiarity with some medical terminology. Experience addressing member inquiries in a managed care environment. Knowledge of CPT and ICD-9 codes. Compliance & Regulatory Responsibilities: Noted above License/Certification: N/A WE ARE AN EQUAL OPPORTUNITY EMPLOYER. HF Management Services, LLC complies with all applicable laws and regulations. Applicants and employees are considered for positions and are evaluated without regard to race, color, creed, religion, sex, national origin, sexual orientation, pregnancy, age, disability, genetic information, domestic violence victim status, gender and/or gender identity or expression, military status, veteran status, citizenship or immigration status, height and weight, familial status, marital status, or unemployment status, as well as any other legally protected basis. HF Management Services, LLC shall not discriminate against any disabled employee or applicant in regard to any position for which the employee or applicant is otherwise qualified. 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 . In your email please include a description of the accommodation you are requesting and a description of the position for which you are applying. Only reasonable accommodation requests related to applying for a position within HF Management Services, LLC will be reviewed at the e-mail address and phone number supplied. Thank you for considering a career with HF Management Services, LLC. Know Your Rights All hiring and recruitment at Healthfirst is transacted with a valid “@healthfirst.org” email address only or from a recruitment firm representing our Company. Any recruitment firm representing Healthfirst will readily provide you with the name and contact information of the recruiting professional representing the opportunity you are inquiring about. 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. Healthfirst will never ask you for money during the recruitment or onboarding process. Hiring Range*: Greater New York City Area (NY, NJ, CT residents): $39,208 - $52,000 All Other Locations (within approved locations): $34,091 - $49,920 As a candidate for this position, your salary and related elements of compensation will be contingent upon your work experience, education, licenses and certifications, and any other factors Healthfirst deems pertinent to the hiring decision. In addition to your salary, Healthfirst offers employees a full range of benefits such as, medical, dental and vision coverage, incentive and recognition programs, life insurance, and 401k contributions (all benefits are subject to eligibility requirements). Healthfirst believes in providing a competitive compensation and benefits package wherever its employees work and live. *The hiring range is defined as the lowest and highest salaries that Healthfirst in “good faith” would pay to a new hire, or for a job promotion, or transfer into this role. Healthfirst is New York’s largest not-for-profit health insurer offering it’s nearly 1.7 million members access to high-quality, affordable healthcare. As part of the community for nearly 30 years, Healthfirst’s unique advantage is rooted in its belief that good health doesn’t start in a doctor’s office. The company’s mission is to put its members first by working closely with care providers and community leaders to address broader issues that can impact health and well-being. This value-based care model is the foundation of the company’s sustained growth in one of the most dynamic markets in the country. So, if you are passionate about what you do and want to work for a company that is focused on the future and dedicated to making a difference in people’s lives, then Healthfirst is for you. Click here to navigate back to the career site!

The Support Coordinator assists care/case managers with non-clinical activities, including creating cases and providing outreach to members and providers. They manage a large volume of tasks and ensure timely communication of member issues while maintaining compliance with HIPAA regulations. | Candidates must have a high school diploma or GED and prior experience in a customer service environment. Proficiency in Microsoft Office Suite and the ability to navigate multiple technologies are preferred. | The Support Coordinator is responsible for assisting the care/case managers with non-clinical activities such as creating cases and events; providing telephonic outreach to members, providers and community-based organizations; handling member mailings; faxing clinical requests and Individual Health Care Plans on behalf of the care/case managers. The Support Coordinator is assigned to a specific clinical team (such as Care Management, Utilization Management, Behavioral Health, etc.) and may have additional departmental responsibilities. Job Description Duties and Responsibilities: Provides excellent quality customer service to our members and/or providers relating to authorization updates, questions/issues such as coordinating care, DME outreach, scheduling appointments, and screen assessments to identify risk factors which need closer intervention Handles calls to and from providers regarding authorizations, referrals, visits, tests, and faxed care plans Manage requests from members, providers, call centers and care management teams regarding initial authorizations, authorization updates and/or corrections Complete member and provider notification calls Escalates calls to appropriate departments which may include but is not limited to inbound/outbound calls on behalf of Care Managers Manages a large volume of tasks and caseloads from multiple queues Meets/Exceeds all performance, quality and productivity measures Builds sustainable relationships of trust through open and interactive communication with internal and external customers Documents accurate member information in compliance with our internal procedures Follows established policies and procedures to ensure member and provider issues are addressed timely and accurately Timely communicates member issues or needs and monitors screening of members effectively to improve quality and cost outcomes Complies with HIPAA requirements and maintains Protected Health Information (PHI) confidentiality of member, provider, medical and departmental information, and adheres to local, state, federal and Healthfirst specific compliance and regulatory guidelines Additional duties as assigned Minimum Qualifications: High School diploma or GED from an accredited institution Prior experience in a customer service environment Working experience in a fast-paced environment Proficient in Microsoft Office Suite applications including Excel, Word, and Outlook Preferred Qualifications: Language preferences - Spanish, Russian, French, Creole, Mandarin, Cantonese. Knowledge of medical terminology Experience in managed care or other area of the healthcare industry working in a Call Center environment or Care/Case Management Department Experience navigating multiple technologies including a Customer Relationship Management System (i.e., locate information, route future actions, notate resolutions, update member information, etc.) Proven track record of exercising independent thinking, problem solving and achieving goals Excellent verbal and written communication and the ability to document grammatically correct emails, communications, and presentations WE ARE AN EQUAL OPPORTUNITY EMPLOYER. HF Management Services, LLC complies with all applicable laws and regulations. Applicants and employees are considered for positions and are evaluated without regard to race, color, creed, religion, sex, national origin, sexual orientation, pregnancy, age, disability, genetic information, domestic violence victim status, gender and/or gender identity or expression, military status, veteran status, citizenship or immigration status, height and weight, familial status, marital status, or unemployment status, as well as any other legally protected basis. HF Management Services, LLC shall not discriminate against any disabled employee or applicant in regard to any position for which the employee or applicant is otherwise qualified. 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 . In your email please include a description of the accommodation you are requesting and a description of the position for which you are applying. Only reasonable accommodation requests related to applying for a position within HF Management Services, LLC will be reviewed at the e-mail address and phone number supplied. Thank you for considering a career with HF Management Services, LLC. Know Your Rights All hiring and recruitment at Healthfirst is transacted with a valid “@healthfirst.org” email address only or from a recruitment firm representing our Company. Any recruitment firm representing Healthfirst will readily provide you with the name and contact information of the recruiting professional representing the opportunity you are inquiring about. 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. Healthfirst will never ask you for money during the recruitment or onboarding process. Hiring Range*: Greater New York City Area (NY, NJ, CT residents): $39,208 - $52,000 All Other Locations (within approved locations): $34,091 - $49,920 As a candidate for this position, your salary and related elements of compensation will be contingent upon your work experience, education, licenses and certifications, and any other factors Healthfirst deems pertinent to the hiring decision. In addition to your salary, Healthfirst offers employees a full range of benefits such as, medical, dental and vision coverage, incentive and recognition programs, life insurance, and 401k contributions (all benefits are subject to eligibility requirements). Healthfirst believes in providing a competitive compensation and benefits package wherever its employees work and live. *The hiring range is defined as the lowest and highest salaries that Healthfirst in “good faith” would pay to a new hire, or for a job promotion, or transfer into this role. Healthfirst is New York’s largest not-for-profit health insurer offering it’s nearly 1.7 million members access to high-quality, affordable healthcare. As part of the community for nearly 30 years, Healthfirst’s unique advantage is rooted in its belief that good health doesn’t start in a doctor’s office. The company’s mission is to put its members first by working closely with care providers and community leaders to address broader issues that can impact health and well-being. This value-based care model is the foundation of the company’s sustained growth in one of the most dynamic markets in the country. So, if you are passionate about what you do and want to work for a company that is focused on the future and dedicated to making a difference in people’s lives, then Healthfirst is for you. Click here to navigate back to the career site!