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Community First Health Plan Jobs (NOW HIRING)

Geisinger Health

Pharmacist Health Plan

Danville, PA · On-site +1

$66.75 - $80/hr

Job Duties: * Act as a liaison between the Health Plan and its customers with respect to ... We constantly seek new and better ways to care for our patients, our members, our community, and ...

Geisinger

Pharmacist Health Plan

Danville, PA

$66.75 - $80/hr

Job Duties * Act as a liaison between the Health Plan and its customers with respect to ... We constantly seek new and better ways to care for our patients, our members, our community, and ...

Adventist Health

Health Plan Claims Examiner

Roseville, CA · On-site

$24.40 - $32.49/hr

Processes medical claims for payment up to $15,000.00 per Health Plan benefit descriptions. Assists ... communities on the West Coast and Hawaii with over 440 sites of care, including 27 acute care ...

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$79K

$109K

How much do community first health plan jobs pay per year?

As of Jun 12, 2026, the average yearly pay for community first health plan in the United States is $78,995.00, according to ZipRecruiter salary data. Most workers in this role earn between $68,000.00 and $90,500.00 per year, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a Community Health Plan Administrator, and why are they important?

To thrive as a Community Health Plan Administrator, you need a solid understanding of healthcare management, insurance regulations, and population health, often supported by a degree in healthcare administration or public health. Familiarity with healthcare management systems, claims processing software, and regulatory compliance tools is typically required. Strong leadership, interpersonal communication, and problem-solving skills help you coordinate teams and engage with diverse stakeholders. These skills ensure effective plan operations, regulatory compliance, and improved health outcomes for community members.

What is the difference between Community First Health Plan vs Community Health Worker?

AspectCommunity First Health PlanCommunity Health Worker
CredentialsVaries; often requires health-related certifications or licensesTypically requires a high school diploma; some roles need certification
Work EnvironmentHealthcare settings, clinics, community outreach programsCommunity-based settings, homes, clinics
Employer & IndustryHealth insurance providers, healthcare organizationsNonprofits, healthcare agencies, community organizations
Primary FocusProviding health coverage, managing patient careEducating, advocating, and connecting community members to health services

While Community First Health Plan focuses on health coverage and care management, Community Health Workers engage directly with communities to promote health and connect individuals to services. Both roles are vital in healthcare but serve different functions within the industry.

What are some common challenges faced by employees working at Community First Health Plan, and how can new hires effectively navigate them?

Employees at Community First Health Plan often encounter challenges such as adapting to regulatory changes in healthcare, managing diverse member needs, and collaborating across multidisciplinary teams. New hires can effectively navigate these by staying informed about state and federal healthcare guidelines, seeking mentorship from experienced colleagues, and proactively communicating within their teams. Embracing continuous learning and participating in internal training sessions are also valuable strategies for success and professional growth within the organization.

What is Community First Health Plan?

Community First Health Plan is a non-profit health insurance organization that provides healthcare coverage to individuals and families, primarily in the San Antonio and South Texas region. They offer a range of health plans, including Medicaid, CHIP (Children’s Health Insurance Program), and commercial group plans. The organization focuses on improving community health by offering accessible, affordable, and quality healthcare services. Community First Health Plan partners with local healthcare providers to ensure members receive comprehensive care and support.
More about Community First Health Plan jobs
What cities are hiring for Community First Health Plan jobs? Cities with the most Community First Health Plan job openings:
What states have the most Community First Health Plan jobs? States with the most job openings for Community First Health Plan jobs include:
What job categories do people searching Community First Health Plan jobs look for? The top searched job categories for Community First Health Plan jobs are:
Community First Health Plan jobs near you
Infographic showing various Community First Health Plan job openings in the United States as of June 2026, with employment types broken down into 1% As Needed, 65% Full Time, 24% Part Time, and 10% Contract. Highlights an 96% Physical, 1% Hybrid, and 3% Remote job distribution, with an average salary of $78,995 per year, or $38 per hour.
Director, Audit Services - Community First Health Plans CFHP

Director, Audit Services - Community First Health Plans CFHP

University Health

San Antonio, TX • On-site

$40.87 - $91.35/hr

Full-time

Posted 5 days ago

University Of Nevada (Reno) rating

8.4

Company rating: 8.4 out of 10

Based on 15 frontline employees who took The Breakroom Quiz

76th of 536 rated colleges and universities

Job description

POSITION SUMMARY /RESPONSIBILITIES
Community First Health Plans, Inc. (Community First) is a Health Maintenance Organization (HMO) providing health care services to Medicaid, CHIP, Medicare, and Marketplace recipients. Community First also provides commercial and self-funded insurance to members. Community First must ensure that all operations are aligned with the regulatory requirements of the Texas Health and Human Services Commission (HHSC), the Texas Department of Insurance (TDI), the Centers for Medicare and Medicaid Services (CMS), and the National Association of Insurance Commissioners (NAIC). Collaborates with all leaders and departments throughout the course of the audit function, promoting a team-oriented environment.
EDUCATION/EXPERIENCE
Bachelor's degree is required in accounting or healthcare-related field with at least three years' experience in professional healthcare audit services, interpretation of Texas Medicaid Managed Care regulations, Texas Department of Insurance regulations, and/or HHSC OIG Medicaid Managed Care SIU regulations. Experience with anti-fraud detection and prevention is required. A master's degree in accounting or related field is preferred. Supervisory experience is preferred. Experience with NAIC Model Audit Rule (MAR) audits and Enterprise Risk Management (ERM) is preferred. Must possess at least one or more relevant professional certifications (i.e., CHC, CIA, CPA, CFE). Preference will be given to a Certified Internal Auditor with AHIMA Coding Certification. Expert knowledge of ICD, CPT, HCPCS coding classifications and DRG, APC, and ASC payment methodology is highly desirable.

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