AmeriHealth Caritas
Role Overview: The Director of Provider Network Operations is responsible for overseeing and managing all local operational functions to ensure efficient performance and compliance. This role ensures that all plan policies and procedures meet applicable regulatory standards, gain appropriate stakeholder…
Your career starts now. We’re looking for the next generation of health care leaders. At AmeriHealth Caritas, we’re passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health care solutions,…
Role Overview: The Market Executive Projects Manager plays a critical role in driving strategic initiatives that enhance operational efficiency, strengthen regulatory compliance, and support overall organizational performance. This role leads cross?functional projects, evaluates and improves processes, and delivers actionable insights…
Responsibilities: Responsible for managing the day to day activities of the DC Medicaid Plan Network Management department and staff. Responsible for assisting the Leader with departmental activities related to provider satisfaction, education, and communication. This position is also responsible for…
Your career starts now. We are looking for the next generation of health care leaders. At AmeriHealth Caritas, we are passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health…
Role Overview Healthcare Value Optimization (HVO) is AmeriHealth Caritas’ enterprise wide margin improvement program, which delivers value for the organization through improved member experience, health outcomes, and total cost of care. HVO collaborates closely with functional and market leaders, following…
Job Description: Under the direct supervision of Operation Supervisors, the Customer Service Representative is responsible for supporting a diverse membership community and their providers as well as other customers in a timely manner. This includes inbound and outbound engagement with…
Job Description: Under the direct supervision of Operation Supervisors, the Customer Service Representative is responsible for supporting a diverse membership community and their providers as well as other customers in a timely manner. This includes inbound and outbound engagement with…
Role Overview: Under the direction of the Supervisor, the Behavioral Health Utilization Management (BHUM) Reviewer is responsible for completing medical necessity reviews. Using clinical knowledge and experience, the clinician reviews provider requests for inpatient and outpatient services, working closely with…
Role Overview: Reporting to the Manager, Leave Administration, the HR Leave and Accommodations Specialist is responsible for the administration of the Leave of Absence (LOA) process, short and long term disability, Family Medical Leave (FMLA), worker’s compensation, and Americans with…
Your career starts now. We’re looking for the next generation of health care leaders. At AmeriHealth Caritas, we’re passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health care solutions,…