amerihealth

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...

Network ContractorThe primary responsibility of the Network Contractor is contracting providers, the contracting and re-contracting of providers in an established market.Work Arrangements:Remote - The associate must reside in Louisiana (LA) and attend site visits to provider and in office meetings in Baton Rouge.Responsibilities:Supports network development...

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...

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: Under the oversight and direction of Financial Reporting management and in support of the Financial Reporting Senior Analyst, responsible for preparing all quarterly and annual external financial statements/reports as required of the Company on the basis of Statement of Statutory Accounting Principles (SSAP). Work Arrangement: Hybrid =...

Network Contractor The primary responsibility of the Network Contractor is contracting providers, the contracting and re-contracting of providers in an established market. Work Arrangements: Remote - The associate must reside in Louisiana (LA) and attend site visits to provider and in office meetings in Baton Rouge. Responsibilities: Supports network...

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 information...

The Associate Account Executive works with the Sales Executive and Functional Management to manage external customer, client, consultant, or broker relationships. Assists in the development and execution of sales strategy for each group, customer or prospect. Participate in sales meetings, presentations, and site visits to cultivate account relationships....

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 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...

This is a 100% remote role but qualified candidates must reside in Michigan and have an active Michigan RN license. 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...

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 Active, unrestricted RN licensure. Sign-on Bonus: Eligible candidates may receive a sign-on bonus starting at $7,500, with the potential for a higher amount based on experience and qualifications.Role Overview: The Director, ICT Care Coordination, is responsible for leading the strategic direction, operational execution, and performance of care...

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...

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 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...

Job Summary In this role, you will lead the operational areas of the Utilization Management (UM) program including prospective, concurrent, and retrospective reviews. As a Medical Director, UM you ensure all patient care decisions and referrals are medically appropriate by using national and local criteria. Our Medical Directors, UM help develop and...

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...