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Results based on filters ( 84 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
apply
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

Senior Provider Network Operations Analyst

AmeriHealth Caritas
Located in Ohio
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data-type="string"> Description : **Role Overview:** The Senior Provider ...
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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 ...
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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

Provider Network Operations Data Analyst

AmeriHealth Caritas
Southfield, MI
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Role Overview: The Provider Network Operations Data Analyst plays a key role ...
Details
Summary
About the job:
in maintaining accurate provider data and fostering strong relationships between the health plan and its contracted and non-contracted providers across Medicaid, Medicare, and Exchange products. This role ensures provider information is correctly represented in all operating systems and serves as a proactive liaison to resolve provider-related issues efficiently. Work Arrangement: - Remote - The associate can work remotely from anywhere in the Detroit Metro area, Michigan, and must be able to attend two weeks of...
Location:
Southfield, MI
Job Type:
Full-Time
Permanent
Occupation:
Business Operations Specialists, All Other
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

Manager Provider Network Operations

AmeriHealth Caritas
Located in Ohio
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data-type="string"> Description : **Job Summary** This position will report ...
Details
Summary
About the job:
to the Director, Provider Network Ops in creation and maintenance of the provider reimbursement business rules for the market. During implementation, the position will be responsible to develop the business rules and associated pricing agreement template to allow for appropriate system set up.The primary purpose of the job is to be responsible for the oversight of the local Plan’s provider data and reimbursement rules and address provider inquiries and complaints. **Responsibilities will include:** + Maintain a...
Location:
Located in Ohio
Job Type:
Full-Time
Permanent
Occupation:
Medical and Health Services 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

Medicare Operations Oversight Specialist

AmeriHealth Caritas
Located in Ohio
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data-type="string"> Description : **Role Overview:** The Medicare ...
Details
Summary
About the job:
Performance Operations Oversight Specialist ensures effective operational oversight across key Medicare business functions, with a specific focus on Grievances, Member Services/Concierge, STARS, and Vendor Management. This role is responsible for monitoring performance, ensuring contractual and regulatory compliance, identifying risks, and supporting continuous improvement efforts. The specialist also serves as a liaison between Medicare Performance Management (MPM) and Shared Services, helping to resolve issues, interpret...
Location:
Located in Ohio
Job Type:
Full-Time
Permanent
Occupation:
Compliance Officers
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

Financial Reporting Analyst Senior

AmeriHealth Caritas
Located in Ohio
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data-type="string"> Description : **Role Overview** The **Financial ...
Details
Summary
About the job:
Reporting Analyst Senior** provides oversight and direction of FP&A management, and assists with consolidated G&A management and analysis. **Work Arrangement** + This is a 100% Remote Position but you must lives in EST or CST time zones **Responsibilities** + Present financial summaries and business insights to FP&A leadership + Develop financial models to support decision making related to Budget, Forecast, monthly G&A analysis and current and historical FTE analysis + Create effective business partnerships, manage competing...
Location:
Located in Ohio
Job Type:
Full-Time
Permanent
Occupation:
Financial and Investment Analysts
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
From:
De jobs
Certifications / Licenses:
Certified Corporate FP&A Professional
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Clinical Business Program Analyst

AmeriHealth Caritas
Located in Ohio
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data-type="string"> Description : **Responsibilities** + Manage Prior ...
Details
Summary
About the job:
Authorization (PA) and Coverage Determination (CD) software applications. + Identify, document, and implement system enhancements and functionality updates based on Federal/State requirements, customer needs, and efficiency opportunities. + Conduct system testing, validate results, and support production deployments. + Identify, troubleshoot, and resolve application defects. + Oversee application user account management. + Manage outbound communications to members, prescribers, and pharmacies. + Manage and audit vendor...
Location:
Located in Ohio
Job Type:
Full-Time
Permanent
Occupation:
Health Information Technologists and Medical Registrars
Career Level / Education:
Associate's degree
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
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