QA Auditor, Appeals and Grievances - Remote
Healthfirst
About this role
A Quality Assurance Auditor at Healthfirst supports the integrity of operational processes and appeals/grievance workflows by evaluating adherence to policies, procedures, and regulatory standards. The role contributes to continuous improvement, documentation, and reporting while working with internal teams and outsourced vendors.
Skills
Qualifications
About Healthfirst
healthfirst.orgHealthfirst is a not‑for‑profit health insurer focused on serving New Yorkers with a range of plans including Medicaid, Medicare Advantage, Child Health Plus, the Essential Plan, and individual & family coverage across New York City, Long Island, Westchester and nearby regions. The company emphasizes coordinated, community‑focused care through a large provider network, care management programs, preventive services, and support for social needs. Healthfirst provides member tools and customer support for plan selection and access to services, and runs quality and population‑health initiatives aimed at improving outcomes and reducing disparities.
Salary
$51k – $80k
per year
More jobs at Healthfirst
Similar Jobs
Appeals and Grievances Nurse
Brigham and Women's Hospital
Senior Manager, Appeals and Grievances Center of Quality and Excellence
USAJOBS
Appeals and Grievances Quality Assurance and Auditing Specialist II
USAJOBS
Appeals Clinical Team Lead
PacificSource Health Plans
Senior Coordinator, Complaint and Appeals (Remote)
CVS Health
Temporary Coordinator remote - Appeals & Grievances - MediGold Health Plan
Loyola Medicine