Healthfirst Project Specialist - Delegate Oversight in New York, New York

Overview:

Company Overview:

Healthfirst is a provider-sponsored health insurance company that serves more than 1.2 million members in downstate New York. With more than 4,000 employees, a network of nearly 30,000 providers, and revenues in excess of $8.6 billion, Healthfirst is one of the largest health plans in the New York City area. Our members are our North Star, and our mission is guided by their needs and preferences in ensuring a superior experience and access to the highest quality healthcare when and where they need it. Healthfirst’s commitment to quality and member satisfaction has helped us earn top ratings for HMO health plans in New York City. We know that employees shape our company and connect us to our communities, and we look to recruit and retain intelligent, driven leaders who are passionate about healthcare and embody our five culture drivers: - Dream Big, Plan Wisely - Break Down the Walls - Think Critically, Speak Up, Deliver with Pride - Inspire Through Trust, Lead By Example - Be Unstoppable

Healthfirst is an Equal Opportunity Employer and does not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity or expression, veterans, disability status or any other characteristic protected by law.

Position Summary:

The Project Specialist is responsible for vendor management in accordance with Healthfirst policies and procedures.

Responsibilities:

Job Duties/Responsibilities:

  • Organize Delegate Oversight workflows, policies, and procedures for our Medicaid, Medicare, and other lines of business

  • Maintain the tracking system to ensure documents are submitted and updated in accordance with established submission schedule

  • Monitors and handles Delegate corrective action plans and reports from regulatory agencies

  • Collaborates closely with Healthfirst departments and other stakeholders to ensure Delegates are in compliance with oversight activities as required by Regulatory agencies. Collaborates with cross-functional departments to complete Desk Audits and Pre-Delegation Audits of Vendors, which ensures all sections of the Pre-Delegated Oversight Tool are complete and accurate

  • Prepare all documents related to Delegate Oversight, including but not limited to Pre-Delegation Oversight Tool, and Delegate Oversight Summary Tool for all Delegates.

  • Provide Manager with monthly departmental metrics and updates as needed

  • Prepare materials, agendas, meeting minutes, and other documents to support active functioning of the Delegate Oversight Subcommittee.

  • Create/prepare an audit schedule in accordance with approved Delegate Oversight policy and procedure, ensure documents are reviewed by cross functional teams, and submitted in organized manner to Delegate Oversight Subcommittee

  • Additional duties as assigned.

Qualifications:

Minimum Qualifications:

  • HS Diploma or GED Equivalent

Preferred Qualifications:

  • Bachelor’s Degree in Business, Communications or Health-Related Field or an equivalent combination of education and/or experience

  • Familiarity with the Delegate Oversight process and some regulatory experience highly preferred.

  • Project management experience

  • 1-3 years of related experience within a managed care environment

  • Computer literacy in Windows environment, particularly Microsoft Excel, Word, PowerPoint, Project and database experience

  • Excellent communication and interpersonal skills

  • Organized, detail oriented, and flexible with assignments

Requisition ID 2017-15489

Job Locations US-NY-New York

Department Name Creden & Delegate Oversig

Equal Opp Statement -

Healthfirst is an Equal Opportunity Employer and does not discriminated against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity or expression, veterans, disability status or any other characteristic protected by law.

Reasonable accommodation statement -

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 1-800-401-6000. 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 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.