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Results based on filters ( 68 jobs found )

Practice Performance Advisor

AmeriHealth Caritas
Southfield, MI
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Role Overview: The Performance Practice Advisor supports the Provider ...
Details
Summary
About the job:
Network Management (PNM) team within a POD-based staffing care model, focusing on provider performance, value-based care (VBC) initiatives, and quality outcomes. This role analyzes provider performance data, identifies improvement opportunities, and partners with providers and internal teams to drive improvements in quality, cost, and overall care delivery. Work Arrangements: - Remote - The associate can be located anywhere in Michigan (MI). - 50% travel is required to the provider's location and attend office meetings at...
Location:
Southfield, MI
Job Type:
Full-Time
Permanent
Occupation:
Management Analysts
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
From:
State of Michigan
Certifications / Licenses:
Driver's License
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Manager Medical Economics & Business Process

AmeriHealth Caritas
Located in Ohio
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Role Overview : The Manager, Medical Economics & Business Process leads a ...
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Summary
About the job:
team responsible for delivering healthcare data and medical economics analyses across a variety of data sources, including claims, authorizations, member, and provider data. This role partners closely with cross ‑ functional teams to structure and execute analyses, generate insights, and identify opportunities to improve medical costs, operational performance, and overall business outcomes. This is a hands-on role, which combines team leadership with active analytic contributions to core workstreams. Work Arrangement: -...
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:
AmeriHealth Caritas
Certifications / Licenses:
N/A
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Community Educator

AmeriHealth Caritas
New Hampshire
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Role Overview: AmeriHealth Caritas New Hampshire (ACNH) is seeking a ...
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Summary
About the job:
passionate and community-driven Community Educator to join our outreach team and help connect vulnerable and diverse populations across the state to essential healthcare resources. Based out of our Manchester Wellness Center and traveling statewide, this role promotes AmeriHealth Caritas programs through community events and site visits, identifies and guides potential Medicaid and uninsured individuals to appropriate services, and educates them on enrollment processes. The Community Educator also coordinates outreach...
Location:
New Hampshire
Job Type:
Full-Time
Permanent
Occupation:
Community and Social Service Specialists, All Other
Career Level / Education:
Bachelor's degree
Salary:
Middle Income Jobs ($30K-$49K)
From:
AmeriHealth Caritas
Certifications / Licenses:
Driver's License
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Care Manager II

AmeriHealth Caritas
Southfield, MI
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Role Overview: The Care Manager II is responsible for managing and ...
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Summary
About the job:
coordinating care, services, and social determinants of health for medically fragile members with acute, chronic, medically complex, and/or behavioral health conditions, as well as other health needs. Serves as the primary point of contact for the care team, including members, caregivers, physicians, and community support, to guide members toward their optimal level of health. Utilizes strong assessment and communication skills, critical thinking, and clinical knowledge to identify issues, gaps in care, and barriers to care....
Location:
Southfield, MI
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:
AmeriHealth Caritas
Certifications / Licenses:
Associate Degree in Nursing
Certified Registered Nurse
National Committee for Quality Assurance
Driver's License
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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Role Overview Under the direction of the Supervisor, the Behavioral Health ...
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Summary
About the job:
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 will use professional judgment to...
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:
AmeriHealth Caritas
Certifications / Licenses:
Licensed Master Social Worker
Licensed Social Worker
Licensed Clinical Social Worker
Licensed Independent Clinical Social Worker
Licensed marriage and family therapist
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Appeals & Grievance Case Resolution Specialist

AmeriHealth Caritas
Located in Ohio
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data-type="string"> Description : _For roles that are 100% remote or hybrid, ...
Details
Summary
About the job:
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 reimbursement._ Your career starts now. We’re looking for the next generation of health care leaders. At AmeriHealth Caritas, we’re passionate about helping people get care, stay well and build healthy...
Location:
Located in Ohio
Job Type:
Full-Time
Permanent
Occupation:
Patient Representatives
Career Level / Education:
Postsecondary nondegree award
Salary:
Upper Middle Income Jobs ($50K-$79K)
From:
De jobs
Certifications / Licenses:
National Committee for Quality Assurance
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

DIRECTOR of FINANCE/CHIEF FINANCIAL OFFICER

AmeriHealth Caritas
Dublin, OH
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Role Overview: The Director of Finance/Chief Financial Officer is ...
Details
Summary
About the job:
responsible for overseeing all accounting and financial operations for the health plan. This role provides strategic and operational financial leadership, ensuring the accuracy, integrity, and compliance of financial reporting while supporting organizational goals through budgeting, forecasting, cost management, and financial analysis. The Director is a key member of the leadership team, partnering closely with leadership, corporate finance, operational leaders, and external stakeholders to support informed decision-making and...
Location:
Dublin, OH
Job Type:
Full-Time
Permanent
Occupation:
Financial Managers
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
From:
RevPath
Certifications / Licenses:
Certified Public Accountant
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Care Connector

AmeriHealth Caritas
Located in Ohio
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data-type="string"> Description : _For roles that are 100% remote or hybrid, ...
Details
Summary
About the job:
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 reimbursement._ Your career starts now. We’re looking for the next generation of health care leaders. At AmeriHealth Caritas, we’re passionate about helping people get care, stay well and build healthy...
Location:
Located in Ohio
Job Type:
Full-Time
Permanent
Occupation:
Healthcare Support Workers, All Other
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

Corporate Director Risk Adjustment Operations

AmeriHealth Caritas
Located in Ohio
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data-type="string"> Description : For roles that are 100% remote or hybrid, ...
Details
Summary
About the job:
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 reimbursement. Your career starts now. We’re looking for the next generation of health care leaders. At AmeriHealth Caritas, we’re passionate about helping people get care, stay well and build healthy...
Location:
Located in Ohio
Job Type:
Full-Time
Permanent
Occupation:
Regulatory Affairs 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

Supervisor Integrated Care Management

AmeriHealth Caritas
Baton Rouge, LA
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data-type="string"> Description : **Role Overview:** The Supervisor, ...
Details
Summary
About the job:
Integrated Case Management, oversees the daily operations of the Case Management unit, providing clinical direction, guidance, and oversight of case management services. **Work Arrangement:** + Remote - Associate must reside in Louisiana (LA) **Responsibilities:** + Provide daily oversight and clinical direction for the Complex Case Management unit. + Supervise and support staff conducting case management, care coordination, and screening activities. + Monitor team performance, productivity, and quality to ensure compliance...
Location:
Baton Rouge, LA
Job Type:
Full-Time
Permanent
Occupation:
Facilities Managers
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
From:
De jobs
Certifications / Licenses:
Certified Registered Nurse
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information
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