
1001 - 5000 employees
Founded 1993
⚕️ Healthcare Insurance
💸 Finance
Healthcare Insurance • Finance • Medicare
Healthfirst is a health insurance provider dedicated to helping New Yorkers access affordable health coverage for individuals and families. With over 30 years of experience, Healthfirst offers a range of plans including Medicaid managed care, Medicare Advantage, long-term care, and essential health plans. The company focuses on providing quality healthcare options, comprehensive benefits, and support to ensure members can maintain their health and well-being.
🕒 January 16
🏄 California, New York, +3 more states – Remote
💵 $103.4k - $149.4k / year
⏰ Full Time
🟡 Mid-level
🟠 Senior
💬 Bilingual
🦅 H1B Visa Sponsor
🗣️🇪🇸 Spanish Required
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1001 - 5000 employees
Founded 1993
⚕️ Healthcare Insurance
💸 Finance
Healthcare Insurance • Finance • Medicare
Healthfirst is a health insurance provider dedicated to helping New Yorkers access affordable health coverage for individuals and families. With over 30 years of experience, Healthfirst offers a range of plans including Medicaid managed care, Medicare Advantage, long-term care, and essential health plans. The company focuses on providing quality healthcare options, comprehensive benefits, and support to ensure members can maintain their health and well-being.
• Support initiatives to resolve gaps in care through direct provider and member outreach, collaboration with provider engagement, and leveraging our pharmacy network capabilities • Ensure that all recommendations are consistent with the latest guidelines or otherwise supported by the clinical compendia • Provide clinical pharmacy support to pharmacy technicians as they conduct outreaches to members regarding med adherence, resolve existing barriers to adherence, and use motivational interviewing to improve health of our members • Collaborate internally with Marketing, IT, and Enterprise Analytics to assist with the creation of strategic digital communication channels for member outreach • Identify and resolve same-day grievances reported by members in a timely manner consistent with our policies and procedures • Oversee and maintain compliance with all State and Federal agencies • Precept Pharmacy Residents and Students • Ensure all clinical criteria is in compliance with Center of Medicare and Medicaid Services (CMS) and the New York State Department of Health (NYSDOH)
• Pharmacy degree from an accredited school of pharmacy • Registered Pharmacist, with a state license in good standing • Work experience requiring written and verbal clinical communication that is clear, concise, grammatically correct, and professional • Knowledge of specialty pharmaceuticals and billing practices in the medical and pharmacy benefits
• medical, dental and vision coverage • incentive and recognition programs • life insurance • 401k contributions
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