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Results based on filters ( 89 jobs found )

Manager Provider Network Operations

AmeriHealth Caritas
Located in Ohio
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data-type="string"> Description : **Job Summary** This position will report ...
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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 ...
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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
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Detailed Job Information

Financial Reporting Analyst Senior

AmeriHealth Caritas
Located in Ohio
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data-type="string"> Description : **Role Overview** The **Financial ...
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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
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Detailed Job Information

Clinical Business Program Analyst

AmeriHealth Caritas
Located in Ohio
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data-type="string"> Description : **Responsibilities** + Manage Prior ...
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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

Medicaid Managed Care Innovation Director

AmeriHealth Caritas
Located in Ohio
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data-type="string"> Description : **Role Overview** The **Innovation ...
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About the job:
Director** within the Growth & Innovation Office leads the design, development, and execution of high-impact innovation initiatives that transform how care and services are delivered to vulnerable and underserved populations, including dually eligible individuals, multi-system youth, and members striving for economic self-sufficiency. This role is responsible for driving differentiated product development, leading strategic demonstrations and pilots, forging unique vendor and external partnerships, and applying...
Location:
Located in Ohio
Job Type:
Full-Time
Permanent
Occupation:
Healthcare Social Workers
Career Level / Education:
Master'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

Healthcare Advanced Analytics Consultant Senior

AmeriHealth Caritas
Located in Ohio
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data-type="string"> Description : **Role Overview** We are seeking a highly ...
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About the job:
motivated and strategic **Advanced Analytics Consultant Senior** to lead the planning, development and delivery of data-driven products across our enterprise ecosystem. This role combines user-centric product thinking, technical acumen, product data discovery, product management to ensure high-impact delivery on a modern data platform—Databricks. The role bridges business needs and engineering - focusing on user engagement, delivery execution, process and engineering automation, and technology innovation. This role...
Location:
Located in Ohio
Job Type:
Full-Time
Permanent
Occupation:
Data Warehousing Specialists
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

Medicaid Managed Care Innovation Manager

AmeriHealth Caritas
Located in Ohio
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data-type="string"> Description : **Role Overview** The **Innovation ...
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Summary
About the job:
Manager** supports the development and execution of high-impact innovation initiatives focused on advancing care and support for complex populations—such as dually eligible members, multi-system youth, and individuals seeking economic self-sufficiency. This role is integral to designing and managing differentiated products, coordinating across systems and stakeholders, and contributing to innovation projects that support enterprise growth, program performance, and improved health outcomes. The Innovation Manager helps...
Location:
Located in Ohio
Job Type:
Full-Time
Permanent
Occupation:
Social Scientists and Related Workers, All Other
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

Wellness Center Admin - Bilingual

AmeriHealth Caritas
Located in Ohio
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data-type="string"> Description : **Role Overview** The Bilingual Wellness ...
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Summary
About the job:
Center (WC) Administrator oversees the operation of the WC. This includes oversight of all WC activities, daily operations, programs, staffing, facility logistics, data tracking, and reception of WC visitors. **Work Arrangement** + On-Site + Travel required to Northampton, Lehigh, Berks, and other surrounding counties in PA, **Responsibilities** + The Bilingual Wellness Center Administrator must demonstrate the ability to speak both English and Spanish, performing the position’s responsibilities in both languages +...
Location:
Located in Ohio
Job Type:
Full-Time
Permanent
Occupation:
Project Management Specialists
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

Salesforce Application Architect

AmeriHealth Caritas
Located in Ohio
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data-type="string"> Description : **Role Overview** We are looking for a ...
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Summary
About the job:
passionate and seasoned **Salesforce CRM Application Architect** who can lead the design and architecture for next-generation Member Engagement capabilities on our Salesforce platform. Reporting to the Director of Member Engagement CRM, the technology leader in this role will provide thought, technology engineering, architecture, delivery and operational leadership for all our lines of businesses. The Application Architect will closely work with Development managers, Lead developers, Enterprise architects to deliver best...
Location:
Located in Ohio
Job Type:
Full-Time
Permanent
Occupation:
Computer Systems Engineers/Architects
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

Salesforce Developer Programmer Senior

AmeriHealth Caritas
Located in Ohio
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data-type="string"> Description : **Role Overview** AmeriHealth Caritas is ...
Details
Summary
About the job:
seeking a dynamic **Salesforce Developer Senior** to join our fast-growing Member Services Salesforce Team. In this role, you will use your ‘can do attitude’, strong Salesforce technical knowledge to deliver and build solutions on AmeriHealth’s Member CRM Salesforce platform. As a team member of Member CRM Team, you will analyze, develop, deliver and triage in the highly challenging and rewarding Healthcare domain and be a critical part of the future of Healthcare IT at AmeriHealth Caritas. **Work Arrangement** + This...
Location:
Located in Ohio
Job Type:
Full-Time
Permanent
Occupation:
Software Developers
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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