amerihealth

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, we offer our associates the opportunity to impact the lives of millions of people through our national...

For roles that are 100% remote or hybrid, you must have access to a reliable high-speed internet connection to support daily job responsibilities. A minimum bandwidth of 50 Mbps download and 5 Mbps upload is required. Those fully remote associates residing in states where service is required by contract, law, or regulation will be allowed to submit for...

**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 members and/or providers via phone calls or correspondence regarding...

The following responsibilities are regarding enrollees with medical conditions and their providers Overseeing the quality of clinical care for network and non-network providers Assuring a high-performing Medical Management system that adheres to the terms of contracts and all relevant regulatory requirements Utilizing evidence-based standards in...

Care Management Opportunities Multiple opportunities | Care Manager RN, LICSW & Behavioral Health Licensure | Hybrid - 4 days onsite, 1 remote $5,000.00 SIGN-ON BONUS 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...

For roles that are 100% remote or hybrid, you must have access to a reliable high-speed internet connection to support daily job responsibilities. A minimum bandwidth of 50 Mbps download and 5 Mbps upload is required. Those fully remote associates residing in states where service is required by contract, law, or regulation will be allowed to submit for...

Your career starts now. We are looking for the next generation of healthcare 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 healthcare solutions, we offer our associates the opportunity to impact the lives of millions of people through our national...

Role Overview The Pediatric Care Manager supports members in achieving optimal health through self-management. Engaging with members, caregivers, and providers, the role involves assessing plans, setting individual goals, and coordinating care to ensure quality and cost-effective resources. This position serves as a single point of contact and advocates...

Provider Network Operations Supervisor The Provider Network Operations Supervisor supports the daily operations of the Provider Network Operations team by overseeing staff performance, ensuring operational efficiency, and maintaining compliance with internal policies and contractual requirements. Work Arrangement: Remote - This position is fully remote;...

Network ContractorFor roles that are 100% remote or hybrid, you must have access to a reliable high-speed internet connection to support daily job responsibilities. A minimum bandwidth of 50 Mbps download and 5 Mbps upload is required. Those fully remote associates residing in states where service is required by contract, law, or regulation will be allowed...

Job Summary As a licensed healthcare professional employed in the Prior Authorization Department, the primary responsibility of the Pharmacist (R) is to make determinations on prior authorization requests for coverage of pharmaceutical products. Determinations include medical necessity and benefit decisions. Decisions are made in accordance with...

AmeriHealth Caritas North Carolina seeks a Manager Social Care to lead community partnerships and implement standardized social care programs across the NC service area. The role requires a Bachelor's degree and at least 3 years of team leadership within a matrix environment, with preference for health plan or managed care outreach experience. Travel up to...

AmeriHealth Caritas is seeking a Maternity Case Manager to support pregnant members through care coordination and case management, ensuring optimal health during pregnancy and postpartum. The role targets experienced nurses with a passion for maternal health and community care, offering flexible work options and strong benefits. Kannapolis, NC-based,...

AmeriHealth Caritas North Carolina seeks a Manager Social Care to lead community partnerships and implement standardized social care programs across the NC service area. The role requires a Bachelor's degree and at least 3 years of team leadership within a matrix environment, with preference for health plan or managed care outreach experience. Travel up to...

AmeriHealth Caritas North Carolina seeks a Manager Social Care to lead community partnerships and implement standardized social care programs across the NC service area. The role requires a Bachelor's degree and at least 3 years of team leadership within a matrix environment, with preference for health plan or managed care outreach experience. Travel up to...

AmeriHealth Caritas North Carolina seeks a Manager Social Care to lead community partnerships and implement standardized social care programs across the NC service area. The role requires a Bachelor's degree and at least 3 years of team leadership within a matrix environment, with preference for health plan or managed care outreach experience. Travel up to...

AmeriHealth Caritas North Carolina seeks a Manager Social Care to lead community partnerships and implement standardized social care programs across the NC service area. The role requires a Bachelor's degree and at least 3 years of team leadership within a matrix environment, with preference for health plan or managed care outreach experience. Travel up to...

AmeriHealth Caritas is seeking a UM Clinical Administrative Operations Liaison to coordinate and monitor utilization management programs, supporting performance improvement and QA activities. The role interacts with policy updates, reporting, and accreditation preparation to ensure regulatory compliance. The ideal candidate holds a Bachelor's degree with at...

Provider Network Operations Supervisor The Provider Network Operations Supervisor supports the daily operations of the Provider Network Operations team by overseeing staff performance, ensuring operational efficiency, and maintaining compliance with internal policies and contractual requirements. Work Arrangement: Remote - This position is fully remote;...

AmeriHealth Caritas North Carolina seeks a Manager Social Care to lead community partnerships and implement standardized social care programs across the NC service area. The role requires a Bachelor's degree and at least 3 years of team leadership within a matrix environment, with preference for health plan or managed care outreach experience. Travel up to...