amerihealth

Role Overview The Investigator is responsible for conducting comprehensive investigations of reported, alleged or suspected fraud involving the full range of products at the AmeriHealth Caritas Family of Companies (ACFC). Work Arrangement • Hybrid- Must reside in DC or surrounding areas contractually: Montgomery, Prince George's, MD, or Arlington or...

Work Arrangement • Qualified candidates must be able to travel to Berks OR Lehigh/Northampton counties in PA. • Must be able to travel up to 75% in the community • Monday thru Friday 8:30 AM - 5 PM EST Sign-On Bonus Available • Eligible Service Coordinators may receive a $3,000 sign-on bonus, paid in two installments after hire. This bonus is...

Work Arrangement • Qualified candidates must be able to travel to York/Adams OR Lancaster/Lebanon counties in PA. • Must be able to travel up to 75% in the community • Monday thru Friday 8:30 AM - 5 PM EST Sign-On Bonus Available • Eligible Service Coordinators may receive a $3,000 sign-on bonus, paid in two installments after hire. This bonus is...

AmeriHealth Caritas is seeking an Actuarial Analyst to join the Medical Economics team in a 100% remote capacity. The role offers participation in the Actuarial Development Program with exam support, mentorship, and rotations.The position requires a Bachelor’s in Actuarial Science or related field, 1–3 actuarial exams, and strong skills in Excel, SQL,...

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...

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...

Role Overview Responsible for managing and coordinating care, services, and social determinants of health for Members with behavioral health conditions and acute, chronic, and medically complex needs. Serves as the primary point of contact for the care team that includes Members, physicians as well as community supports to guide members in achieving their...

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 Member Services Specialists are the first point of contact for youth, families/caregivers and providers. They are responsible for answering all calls within a specific service level agreement and completing the registration process as well as managing questions from treatment providers. Member Services Specialists determines the appropriate...

Role Overview: The Accessibility/QA Specialist performs manual and automated quality assurance and accessibility testing and remediation on numerous websites, portals, and other digital experiences to ensure they meet functional requirements and conform to WCAG 2.2 Level AA guidelines. This is not a software testing position. Must have strong command of the...

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’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...

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 members and providers to collect all...

Integrated Resources, Inc., is led by a seasoned team with combined decades in the industry. We deliver strategic workforce solutions that help you manage your talent and business more efficiently and effectively. Since launching in 1996, IRI has attracted, assembled and retained key employees who are experts in their fields. This has helped us expand into...

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process. Provider Network Account Executive (6 Month Contract) Temporary Full-Time Professional AmeriHealth Caritas DC Washington, DC, US 8 days ago Requisition ID: 1248 Salary Range: $30.00 To $35.00...

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...

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 Summary The primary responsibility of Account Executive is to develop strong relationships with providers to drive for performance, specifically as it relates to core providers as determined by the program who are in fee for service programs and may include PCPs, OB/GYNs, high volume specialists, and FQHCs. Essential Functions • Supports network...

The Assistant Product Manager is responsible for the evaluation and implementation of AmeriHealth group products. Works closely with Product Managers / Sr Product Managers in completing assigned products, coordinating with operating areas to address problems and improving product delivery. Responsibilities • Contributes to the evaluation, implementation...

**Responsibilities** Under the general direction of the ACA Operations Supervisor, responsible for responding in a timely, professional and courteous manner to all and member needs. This includes inbound and outbound phone calls or correspondence regarding benefit, eligibility, member premium billing, and other member issues. Provides member education and...