amerihealth

Care Connector 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...

Work Arrangement:Monday through Friday, 8:30 AM to 5:00 PM4 days must be worked on-site at our DC office located at 1201 Maine SW. The 5th day can be worked remotely from home.Responsibilities will include moderate or low risk member case load.Member Outreach:Establishes connection and acts as the primary ACFC contact to a targeted member population,...

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 OverviewOur Utilization Management Reviewers evaluate medical necessity for inpatient and outpatient services, ensuring treatment aligns with clinical guidelines, regulatory requirements, and patient needs. This role requires reviewing provider requests, gathering necessary medical documentation, and making determinations based on clinical criteria....

Care Connector 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...

AmeriHealth is seeking a College Co-op: Operational Readiness Analyst to join the Remote US team. You will support analytics, QA testing, and reporting to drive business optimization and cost containment across various units. Responsibilities include investigating claims processing, evaluating billing/enrollment challenges, and performing root cause analyses...

Job Summary: The Claims Eligibility Specialist is the point of contact for the Provider community to resolve issues related to Medicaid coverage and services. The incumbent coordinates and collaborates with internal associates and staff from various Provider agencies on Medicaid eligibility and claims issues. In addition to resolving discrepancies in...

Family Nurse Practitioner (FNP)Titan Placement Group invites you to explore an opportunity in Salem, NJ the vibrant and diverse communities of southern New Jersey. This area offers proximity to both Philadelphia and the Jersey Shore, rich cultural traditions, and a strong sense of community. It's an ideal setting for healthcare professionals who are...

This role is hybrid, working (4) days in office and one (1) day remote. 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. Your career starts now. We're looking for the next generation of health care leaders. At AmeriHealth Caritas,...

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 available to...

Role Overview: The Provider Network Management Contractor is responsible for developing, contracting, and maintaining provider relationships within an assigned market. This role ensures the network is competitive, compliant, and aligned with organizational strategy. Work Arrangement: Hybrid - Associate must be in the office at least three (3) days per week...

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 nations leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national...

Work Arrangement: Monday through Friday, 8:30 AM to 5:00 PM 4 days must be worked on-site at our DC office located at 1201 Maine SW. The 5th day can be worked remotely from home. Responsibilities will include moderate or low risk member case load. Member Outreach: Establishes connection and acts as the primary ACFC contact to a targeted member...

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 Brief This is a remote role requiring residency in one of the following counties in North Carolina: Onslow, Jones, Pitt, Duplin, Wayne, Lenoire, or Greene 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...

AmeriHealth is seeking a College Co-op: Operational Readiness Analyst to join the Remote US team. You will support analytics, QA testing, and reporting to drive business optimization and cost containment across various units. Responsibilities include investigating claims processing, evaluating billing/enrollment challenges, and performing root cause analyses...

Role Overview: The Senior Provider Network Operations Analyst serves as a subject matter expert within Provider Network Operations and is responsible for operational accuracy, regulatory compliance, claims configuration, provider data, and related network operations. Work Arrangement • Remote - This position is fully remote and will require the associate...

Community Educator AmeriHealth Caritas New Hampshire (ACNH) is seeking a passionate and community-driven Community Educator to join our outreach team and help connect vulnerable and diverse populations across the state to essential healthcare resources. Based out of our Manchester Wellness Center and traveling statewide, this role promotes AmeriHealth...

Role OverviewThe In-Office Care Manager (RN/LICSW) assists members appropriate for care management and care coordination services in achieving their optimal level of health through self-management. The Care Manager (RN/LICSW) is responsible for engaging the member, member's caregiver and providers to assess, plan, and establish individual member goals. Will...