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Results based on filters ( 68 jobs found )

Provider Claims Service Representative

Amerihealth Caritas Services LLC
Philadelphia, PA
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.** If interested in this position email Jenissa Rodriguez at ...
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Summary
About the job:
jrodriguez@pacareerlinkphl.org and click "apply". Job postings at this company open and close quickly so send Jenissa an email ASAP. For qualified candidates, Jenissa will provide the company's career website to apply, and will follow up with her company contact on your behalf. Responsibilities: ** Under the general direction of the Operations Call Center Supervisor, responsible for responding in a timely, professional and courteous manner to all customer needs. This includes provider phone calls or correspondence regarding...
Location:
Philadelphia, PA
Job Type:
Full-Time
Permanent
Occupation:
Customer Service Representatives
Career Level / Education:
High school diploma or equivalent
Salary:
Middle Income Jobs ($30K-$49K)
From:
Institute of Data
Certifications / Licenses:
N/A
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Vice President Deputy General Counsel (Hybrid)

AmeriHealth Caritas
Newtown Square, PA
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- Not Specified Description: Summary: The Vice President, Deputy General ...
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Summary
About the job:
Counsel will report to the Executive Vice President, General Counsel of AmeriHealth Caritas. The Deputy General Counsel will assist in the development and implementation of comprehensive and proactive legal solutions on a range of matters impacting the organization. Responsible for providing overall leadership and management of a team of attorneys and/or other legal professionals. Strong understanding and experience in some or all of the following areas: Medicare Advantage and dual eligible Medicare/Medicaid plans;...
Location:
Newtown Square, PA
Job Type:
Full-Time
Permanent
Occupation:
Lawyers
Career Level / Education:
Doctoral or professional degree
Salary:
Six Figure Jobs (more than $100K)
From:
Attorney Jobs in USA
Certifications / Licenses:
N/A
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Claims Examiner

AmeriHealth Caritas
Located in Ohio
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Description: The Claims Examiner reports to the Supervisor of Claims. The ...
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About the job:
Claims Examiner is responsible for reviewing and adjudicating claims based on provider and health plan contractual agreements and claims processing guidelines. Responsibilities: Complies with all internal processes and procedures to ensure activities are handled in accordance with departmental and company policies and procedures. Review, research, analyze, and process complex healthcare claims by navigating multiple computer systems and platforms and accurately capturing the data/information for processing (e.g. verify...
Location:
Located in Ohio
Job Type:
Full-Time
Permanent
Occupation:
Claims Adjusters, Examiners, and Investigators
Career Level / Education:
High school diploma or equivalent
Salary:
Upper Middle Income Jobs ($50K-$79K)
From:
AmeriHealth Caritas
Certifications / Licenses:
N/A
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Research Analyst

AmeriHealth Caritas
Located in Ohio
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Your career starts now. We are looking for the next generation of health ...
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About the job:
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 care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we would like to...
Location:
Located in Ohio
Job Type:
Full-Time
Permanent
Occupation:
Claims Adjusters, Examiners, and Investigators
Career Level / Education:
High school diploma or equivalent
Salary:
Upper Middle Income Jobs ($50K-$79K)
From:
AmeriHealth Caritas
Certifications / Licenses:
N/A
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

CUSTOMER SERVICE REPRESENTATIVE - Philadelphia, PA

AmeriHealth Caritas
Philadelphia, PA
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3353653 No 6090 5519 1 06-Feb-2026 Auto req ID 465109BR Company AmeriHealth ...
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About the job:
Caritas Job Code Health-Services health-services Job Description On behalf of VetJobs/MilitarySpouseJobs, thank you for your interest. We are assisting our partnering company, listed below, with this position. It is open to Veterans, Transitioning Military, National Guard Members, Military Spouses, Wounded Warriors, and their Caregivers. If you have the required skill set, education requirements, and experience, please click the submit button and follow for next steps. Under the direct supervision of the operations...
Location:
Philadelphia, PA
Job Type:
Full-Time
Permanent
Occupation:
Customer Service Representatives
Career Level / Education:
High school diploma or equivalent
Salary:
Middle Income Jobs ($30K-$49K)
From:
Military Spouse Corporate Career Network (MSCCN)
Certifications / Licenses:
N/A
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Personal Care Connector

AmeriHealth Caritas
Located in Ohio
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data-type="string"> Description : Your career starts now. We’re looking for ...
Details
Summary
About the job:
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 footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make...
Location:
Located in Ohio
Job Type:
Full-Time
Permanent
Occupation:
Customer Service Representatives
Career Level / Education:
High school diploma or equivalent
Salary:
Upper Middle Income Jobs ($50K-$79K)
From:
De jobs
Certifications / Licenses:
N/A
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Behavioral Health Utilization Management Reviewer

AmeriHealth Caritas
Located in Ohio
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data-type="string"> Description : **Role Overview** Under the direction of ...
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Summary
About the job:
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 necessary to perform a thorough medical necessity review. It is within the BH UM Reviewer’s discretion to retain requests for additional information and/or request clarification. The BH UM Reviewer...
Location:
Located in Ohio
Job Type:
Full-Time
Permanent
Occupation:
Healthcare Social Workers
Career Level / Education:
Master's degree
Salary:
Upper Middle Income Jobs ($50K-$79K)
From:
De jobs
Certifications / Licenses:
Licensed Master Social Worker
Licensed marriage and family therapist
Licensed Social Worker
Licensed Clinical Social Worker
Licensed Independent Clinical Social Worker
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

UAT Testing Analyst

AmeriHealth Caritas
Located in Ohio
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data-type="string"> Description : **Role Overview:** Under the direction of ...
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Summary
About the job:
the UAT Team Lead, the UAT Testing Analyst executes comprehensive functional and regression test plans in support of global system changes. Supports testing for all projects and required changes that impact systems from start to finish. **Work Arrangements:** + Remote- Associate can work remotely anywhere in the United States **Responsibilities:** + Represents UAT in meetings with stakeholders as required + Manage multiple cases/projects for multiple LOBs + Must meet established standard levels of agreement (SLA’s)...
Location:
Located in Ohio
Job Type:
Full-Time
Permanent
Occupation:
Software Quality Assurance Analysts and Testers
Career Level / Education:
Bachelor's degree
Salary:
High Income Jobs ($80K-$99K)
From:
De jobs
Certifications / Licenses:
N/A
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Care Manager

AmeriHealth Caritas
Washington
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data-type="string"> Description : **Role Overview** The In-Office Care ...
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Summary
About the job:
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 facilitate and coordinate care for the members while assuring quality and use of cost-effective resources. The position will function as a single point of contact and be an advocate for members in the...
Location:
Washington
Job Type:
Full-Time
Permanent
Occupation:
Personal Care Aides
Career Level / Education:
High school diploma or equivalent
Salary:
Middle Income Jobs ($30K-$49K)
From:
De jobs
Certifications / Licenses:
Driver's License
Licensed Independent Clinical Social Worker
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Market Executive Projects Manager

AmeriHealth Caritas
Southfield, MI
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Role Overview: The Market Executive Projects Manager (PM) plays a critical ...
Details
Summary
About the job:
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 through data analysis, reporting, and executive-level presentations. The PM partners closely with leadership and key internal and external stakeholders to ensure operational alignment with organizational goals and state requirements. Additionally,...
Location:
Southfield, MI
Job Type:
Full-Time
Permanent
Occupation:
Management Analysts
Career Level / Education:
Bachelor's degree
Salary:
High Income Jobs ($80K-$99K)
From:
State of Michigan
Certifications / Licenses:
N/A
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information
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