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HealthfirstHE

Program Coordinator

Healthfirst is a not-for-profit health insurer based in New York, providing a range of affordable health plans and emphasizing community health.

Healthfirst

Employee count: 1001-5000

Salary: 34k-52k USD

United States only
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, LLCshallnotdiscriminateagainstanydisabledemployeeorapplicantinregard 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.

About the job

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Job type

Full Time

Experience level

Entry-level

Salary

Salary: 34k-52k USD

Location requirements

Hiring timezones

United States +/- 0 hours

About Healthfirst

Learn more about Healthfirst and their company culture.

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Healthfirst has been a dedicated partner in providing affordable healthcare solutions to New Yorkers for over 30 years. Founded by a coalition of leading hospitals, we have created a model that focuses on transitioning the healthcare system towards value-based care—where the quality of care is prioritized over volume. Our extensive network includes nearly 2 million members across New York City and beyond, encompassing a variety of products such as Medicaid, Medicare Advantage, Child Health Plus, and Essential Plans. With a commitment to enhancing healthcare access and outcomes, we offer comprehensive services that include individualized care coordination, tailored health plans for all ages, and many community health initiatives.

At Healthfirst, we place significant emphasis on community engagement, driving efforts to partner with local organizations to ensure that healthcare reaches those who need it most. Our dedicated workforce is more than just an insurance provider; we serve as proactive allies in the health journey of our members. This includes providing essential resources for managing long-term health conditions, access to necessary screenings, and supportive services that encourage healthy lifestyles. As part of our mission, we actively seek to eliminate barriers to healthcare, ensuring every member can access the benefits and services they deserve, thereby promoting overall wellness and longevity in the communities we serve.

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