Hospital Specialist

Healthfirst; New York (NY); On-site; USD 59,000 - 80,000; Full time

Job summary

Healthfirst is seeking a Hospital Specialist to ensure operational efficiency between Healthfirst and our network hospitals. The role reports onsite to our 100 Church Street office Tuesday-Thursday and focuses on payer-provider collaboration.

Responsibilities include handling day-to-day issues, educating on initiatives, and advocating for hospital providers while working with operations, sales and finance teams. Requires direct managed care experience and strong communication skills.

Qualifications

• Direct experience with managed care operations and/or health plans.
• Experience with claims issues including root-cause analysis and system setup.
• Strong verbal and written communication skills.
• Ability to work collaboratively and influence multiple levels of staff and clients.
• Excellent organizational skills and attention to detail.
• Proven ability to develop relationships with external and internal stakeholders.
• Strong problem-solving abilities and analytical mindset.

Responsibilities

• Serve as the primary liaison to hospital partners to maximize operational efficiency.
• Manage day-to-day operational issues, roster maintenance, and claim root-cause analysis.
• Provide education and training on new products, regulatory initiatives, and business objectives.
• Advocate for Hospital Providers within Healthfirst and coordinate with operations, sales, and finance.

Skills

Communication

Problem-solving

Attention to detail

Relationship building

Collaboration

Microsoft Office

Education

Bachelor’s degree

Tools

Microsoft Office

Job description

The Hospital Specialist is the point person responsible for ensuring maximization of operational efficiency between Healthfirst and our network hospitals. This role is required to report onsite to our 100 Church Street office Tuesday-Thursday.

Responsibilities

• Managing day to day operational issues and concerns from hospital partners including but not limited to roster maintenance and claim issue root cause analysis
• Managing education/training regarding company-wide initiatives including but not limited to new product implementation, regulatory initiatives, and other various health plan business objectives
• Serving as an advocate for Hospital Providers within Healthfirst
• Work closely with numerous departmental partners, including operations, sales and finance

Minimum Requirements

• Direct experience working with managed care operations and/or health plans
• Claims experience including root-cause analysis, system set-up, etc
• Strong communication skills (both verbal and written)
• Ability to work collaboratively, confidently and influentially various levels of staff and clients
• Excellent organizational skills
• Demonstrated ability to focus on the most tedious of details, while also being able to solve issues that are larger and more complex
• Ability to develop relationships and partner with external and internal business stakeholders
• Strong problem-solving skills
• Proficiency with Microsoft suite of applications

Preferred Qualifications

• Bachelor’s degree from an accredited institution

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 [e-mail] 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): $58,900 - $80,070

All Other Locations (within approved locations): $51,000 - $75,905

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.

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.