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Results based on filters ( 88 jobs found )

Senior Provider Performance Analyst

AmeriHealth Caritas
Located in Ohio
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data-type="string"> Description : **Role Overview:** The Senior Provider ...
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About the job:
Performance Analyst is responsible for developing, maintaining, and administering provider incentive models. **Work Arrangement:** + Remote - This role may be performed from any location within the United States. **Responsibilities:** + Develop, maintain, and execute provider incentive models across the enterprise. + Ensure the highest levels of data accuracy, integrity, consistency, and completeness across internal and external sources, including Oracle data warehouses. + Identify data-related issues and perform root...
Location:
Located in Ohio
Job Type:
Full-Time
Permanent
Occupation:
Business Intelligence Analysts
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
From:
De jobs
Certifications / Licenses:
N/A
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
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Detailed Job Information

Community Health Navigator

AmeriHealth Caritas
Located in Ohio
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data-type="string"> Description : At AmeriHealth Caritas, we’re passionate ...
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About the job:
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 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. We'd like to hear from you if you want to make a difference. Headquartered in Newtown Square,...
Location:
Located in Ohio
Job Type:
Full-Time
Permanent
Occupation:
Community Health Workers
Career Level / Education:
High school diploma or equivalent
Salary:
Middle Income Jobs ($30K-$49K)
From:
De jobs
Certifications / Licenses:
Driver's License
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Medicare Product Manager

AmeriHealth Caritas
Located in Ohio
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data-type="string"> Description : **Role Overview:** The Medicare Product ...
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Summary
About the job:
Manager is responsible for managing the Medicare product portfolio and supporting strategic initiatives that drive Medicare integration, growth, and market expansion. This role plays a critical part in enhancing plan performance, entering new markets, optimizing benefit design, and ensuring compliance with state and federal regulations. **Work Arrangement:** + Remote - Associate can be located anywhere in the United States **Responsibilities:** + Oversee the full end-to-end product management cycle for Medicare...
Location:
Located in Ohio
Job Type:
Full-Time
Permanent
Occupation:
Market Research Analysts and Marketing Specialists
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
From:
De jobs
Certifications / Licenses:
Certified Marketing Specialist
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Pharmacy Business Systems Analyst

AmeriHealth Caritas
Located in Ohio
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data-type="string"> Description : **PerformRx** is a Pharmacy Benefits ...
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About the job:
Manager (PBM) dedicated to clinical culture, boutique service, and holistic solutions. Our mission is to help clients, providers, and members use effective medication therapy to improve health and wellness. For over two decades, our focus has been on providing optimal service through a clinical culture that seeks to provide members with high-quality care while ensuring our partners receive favorable costs. That culture is reflected in our employees — more than 80 percent of our staff members are Pharmacists and Pharmacy...
Location:
Located in Ohio
Job Type:
Full-Time
Permanent
Occupation:
Management Analysts
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
From:
De jobs
Certifications / Licenses:
N/A
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Vice President Provider Enrollment Service

AmeriHealth Caritas
Located in Ohio
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data-type="string"> Description : Reporting to the Senior Vice President, ...
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About the job:
Enterprise Operations, the Vice President, Provider Enrollment Services is responsible for the enterprise direction and organization of all transactional processing activities of provider enrollment including credentialing, recredentialing and data maintenance. This role is responsible for ensuring all areas meet their established SLAs, stringent quality standards and regulatory requirements. In addition, this role supports new market entry processes as it relates to provider network development including provider...
Location:
Located in Ohio
Job Type:
Full-Time
Permanent
Occupation:
General and Operations Managers
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
From:
De jobs
Certifications / Licenses:
N/A
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Medical Director, Utilization Management

AmeriHealth Caritas
Located in Ohio
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data-type="string"> Description : **Role Overview:** The Medical Director, ...
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Summary
About the job:
Utilization Management, provides organizational leadership in the operational areas of appeals, utilization review, quality improvement, and related policy and practice initiatives in collaboration with the Corporate Medical Directors, Utilization Management and the Vice President, Medical Affairs. ; **Work Arrangement:** + Remote role. + Monday through Friday from 8:30a EST to 5:00p EST. + Weekend call once per quarter and evening call once per quarter.; **Responsibilities:** + Ensures quality and clinically sound...
Location:
Located in Ohio
Job Type:
Part-Time
Full-Time
Permanent
Occupation:
Medical and Health Services Managers
Career Level / Education:
Bachelor's degree
Salary:
High Income Jobs ($80K-$99K)
From:
De jobs
Certifications / Licenses:
Board Certified
Medical License
Board Certified In Family Medicine
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Provider Network Account Executive II

AmeriHealth Caritas
Washington
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data-type="string"> Description : **Summary** The Provider Network Account ...
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Summary
About the job:
Executive II (AE II)is responsible for developing the strategic direction and management of theday-to-daynetwork management activities for all provider types, including single or multiple practices in single or multiple locations, integrated delivery systems, or other provider organizations. AE IIthoroughly understands the Plan’s contracts and provider performance and needs,identifies, develops, and conducts relevant and tailored provider orientation sessions, makes educationalvisits, and works to resolve provider...
Location:
Washington
Job Type:
Full-Time
Permanent
Occupation:
Logistics Analysts
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
From:
De jobs
Certifications / Licenses:
Driver's License
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Senior Provider Network Operations Analyst

AmeriHealth Caritas
Located in Ohio
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data-type="string"> Description : **Role Overview:** The Senior Provider ...
Details
Summary
About the job:
Network Operations Analyst responsible for maintaining current provider data and provider reimbursement setup, and to address provider and state inquiries as they relate to claim payment issues. **Work Arrangement:** + Hybrid – The associate must be in the office at least three (3) days per week at our Manchester, New Hampshire (NH) location. **Responsibilities:** + Review/approves and audits Payment Integrity (PI) vendor and internal prospective and retrospective edits/projects/recoveries + User Acceptance Testing...
Location:
Located in Ohio
Job Type:
Full-Time
Permanent
Occupation:
Business Operations Specialists, All Other
Career Level / Education:
Bachelor's degree
Salary:
High Income Jobs ($80K-$99K)
From:
De jobs
Certifications / Licenses:
National Healthcareer Association
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Director of Finance

AmeriHealth Caritas
Located in Ohio
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data-type="string"> Description : **Role Overview:** The Finance Director ...
Details
Summary
About the job:
oversees all accounting and financial operations for the health plan or line of business, including audit coordination, financial planning, reporting, and budget management. This role ensures the integrity and efficiency of day-to-day financial activities and supports strategic financial decision-making. **Work Arrangement:** + Remote - The associate can be located anywhere in the United States but must be willing to travel to Manchester, New Hampshire as needed. ; **Responsibilities:** + Lead the development and...
Location:
Located in Ohio
Job Type:
Full-Time
Permanent
Occupation:
Treasurers and Controllers
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
From:
De jobs
Certifications / Licenses:
Certified Public Accountant
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

FACETS Business Systems Analyst

AmeriHealth Caritas
Located in Ohio
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data-type="string"> Description : **Role Overview** The **Facets ...
Details
Summary
About the job:
Configuration Business Systems Analyst** analyzes a wide range of FACETS configuration change requests for the purpose of determining the technical scope of the change, the impact on existing system configuration, and ultimately the exact nature of the modifications required to implement the change. The position requires a thorough understanding and knowledge of relational database theory as well as technical testing methodologies. **Work Arrangement** + This is a 100% remote position **Responsibilities** + Serves as a technical...
Location:
Located in Ohio
Job Type:
Full-Time
Permanent
Occupation:
Computer Systems Analysts
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
From:
De jobs
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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