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355 Social Services jobs

Utilization Management RN/LPN

Healthfirst Inc. — New York, NY,

. The Case Manager, Utilization Management is also responsible for efficient utilization of health services ... /Responsibilities: Provides case management services for assigned member caseloads which includes: Pre ... to evaluate the appropriateness and medical necessity of treatments and service utilizations based

Reference no: 1067147 Posted on: 04/22/2021
Utilization Management - Foster Care

Healthfirst Inc. — New York, NY,

coordination of the member's health care services. The Care Manager is assigned to a specific product line ... beneficiaries on services, self-management techniques, and health benefits. Conducts assessments ... referrals to providers, community-based resources, and appropriate services and other resources to assist

Reference no: 1067149 Posted on: 04/22/2021
Support Coordinator - Bilingual Spanish

Healthfirst Inc. — New York, NY,

within Healthfirst Management Services will be reviewed at the e-mail address and phone number supplied ... . Thank you for considering a career with Healthfirst Management Services. EEO Law Poster ... The Support Coordinator is responsible for assisting the care/case managers with non-clinical

Reference no: 1067150 Posted on: 04/22/2021
Case Manager - Foster Care

Healthfirst Inc. — New York, NY,

. The Case Manager, Utilization Management is also responsible for efficient utilization of health services ... case management services for assigned member caseloads which includes: o Pre-certification ... the appropriateness and medical necessity of treatments and service utilizations based on clinical documentation

Reference no: 1066603 Posted on: 04/21/2021
Utilization Management - Foster Care

Healthfirst Inc. — New York, NY,

coordination of the member's health care services. The Care Manager is assigned to a specific product line ... beneficiaries on services, self-management techniques, and health benefits. Conducts assessments ... referrals to providers, community-based resources, and appropriate services and other resources to assist

Reference no: 1066604 Posted on: 04/21/2021
Team Leader, A&G Quality Assurance

Healthfirst Inc. — New York, NY,

for a position within Healthfirst Management Services will be reviewed at the e-mail address and phone ... number supplied. Thank you for considering a career with Healthfirst Management Services. EEO Law ... The Quality Assurance Team Leader in Appeals and Grievances is responsible for managing

Reference no: 1066605 Posted on: 04/21/2021
Dental Peer Reviewer - NY Licensed D.M.D ... . or D.D.S.

Healthfirst Inc. — New York, NY,

Healthfirst Management Services will be reviewed at the e-mail address and phone number supplied ... . Thank you for considering a career with Healthfirst Management Services. EEO Law Poster ... A vital role of the CMO Administration team, the Dental Peer Reviewer plays a critical role

Reference no: 1066606 Posted on: 04/21/2021
Pediatric Care Manager

Healthfirst Inc. — New York, NY,

. Collaborates with provider doctors, social workers, discharge planners, and community based service providers ... coordination of the member's health care services. The Care Manager plans and manages behavioral ... when engaging members and addressing coordination of the member's health care services. Adhere

Reference no: 1066977 Posted on: 04/21/2021
Clinical Service Auditor

Healthfirst Inc. — New York, NY,

, Commercial) and knowledge of Department of Health (DOH) and Local Department of Social Services ... The Clinical Service Auditor examines claims and service authorizations to determine and correct ... and service authorizations for completeness and accuracy. - Reviews different large sets of claims

Reference no: 1066984 Posted on: 04/21/2021
Clinical Auditor: Appeals and Grievance, RN ... or LPN

Healthfirst Inc. — New York, NY,

, Commercial) and knowledge of Department of Health (DOH) and Local Department of Social Services ... and Center for Medicare &Medicaid Services(CMS) regulations pertaining to managed care; nursing experience ... Management Services will be reviewed at the e-mail address and phone number supplied. Thank you

Reference no: 1066985 Posted on: 04/21/2021
Project Manager- Clinical Implementation

Healthfirst Inc. — New York, NY,

of Department of Health (DOH) and Center for Medicare & Medicaid Services (CMS) regulations. Experience leading ... within Healthfirst Management Services will be reviewed at the e-mail address and phone number supplied ... . Thank you for considering a career with Healthfirst Management Services. EEO Law Poster

Reference no: 1066994 Posted on: 04/21/2021
Manager, Clinical Quality

Healthfirst Inc. — New York, NY,

This position responsible for improving the quality of care and services provided to our members ... receive appropriate services. - Lead and/or participate in interactions with all assigned network ... groups about missing services lists. - Maintain medical records department contacts, and knowledge

Reference no: 1067012 Posted on: 04/21/2021
Certified Pharmacy Technician, UM

Healthfirst Inc. — New York, NY,

rapport with Provider offices, strong communication and customer service skills. The CPT position ... of regulations of the Centers for Medicare and Medicaid Services including but not limited to National ... Services will be reviewed at the e-mail address and phone number supplied. Thank you for considering

Reference no: 1067013 Posted on: 04/21/2021
Certified Pharmacy Technician - Bilingual Spanish ... /English

Healthfirst Inc. — New York, NY,

rapport with Provider offices, strong communication and customer service skills. The CPT position ... of regulations of the Centers for Medicare and Medicaid Services including but not limited to National ... Services will be reviewed at the e-mail address and phone number supplied. Thank you for considering

Reference no: 1067014 Posted on: 04/21/2021
Case Manager - Foster Care

Healthfirst Inc. — New York, NY,

. The Case Manager, Utilization Management is also responsible for efficient utilization of health services ... case management services for assigned member caseloads which includes: o Pre-certification ... the appropriateness and medical necessity of treatments and service utilizations based on clinical documentation

Reference no: 1067018 Posted on: 04/21/2021
Utilization Management - Foster Care

Healthfirst Inc. — New York, NY,

coordination of the member's health care services. The Care Manager is assigned to a specific product line ... beneficiaries on services, self-management techniques, and health benefits. Conducts assessments ... referrals to providers, community-based resources, and appropriate services and other resources to assist

Reference no: 1067019 Posted on: 04/21/2021
Team Leader, Non-Clinical Specialist

Healthfirst Inc. — New York, NY,

of clinical and non-clinical services. A&G works in collaboration with divisions within and outside ... Healthfirst Management Services will be reviewed at the e-mail address and phone number supplied. Thank ... you for considering a career with Healthfirst Management Services. EEO Law Poster and Supplement All

Reference no: 1067027 Posted on: 04/21/2021
Bilingual Spanish Care Manager

Healthfirst Inc. — New York, NY,

coordination of the member's health care services. The Care Manager is assigned to a specific product line ... beneficiaries on services, self-management techniques, and health benefits. Conducts assessments ... referrals to providers, community-based resources, and appropriate services and other resources to assist

Reference no: 1067032 Posted on: 04/21/2021
Care Manager

Healthfirst Inc. — New York, NY,

coordination of the member's health care services. The Care Manager is assigned to a specific product line ... beneficiaries on services, self-management techniques, and health benefits. Conducts assessments ... to providers, community-based resources, and appropriate services and other resources to assist in goal

Reference no: 1067046 Posted on: 04/21/2021
Clinical Performance Manager

Healthfirst Inc. — New York, NY,

This position is responsible for improving the quality of care and services provided to our members ... primarily works with Licensed Home Care Services Agencies (LHCSAs) in the Healthfirst Network ... | Ability to travel within the Healthfirst NY service area, including five (5) Boroughs, Nassau and Suffolk

Reference no: 1067048 Posted on: 04/21/2021

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