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Results based on filters ( 111 jobs found )

Market Chief Medical Officer

AmeriHealth Caritas
Baton Rouge, LA
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Role Overview : The Chief Medical Officer (CMO) serves as the senior ...
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Summary
About the job:
clinical executive for the market, reporting directly to the Market President. This role leads the clinical strategy, population health initiatives, and quality improvement efforts to drive better health outcomes and cost-effective care delivery. The CMO collaborates with internal teams, providers, community stakeholders, and regulatory agencies to promote clinical excellence and operational efficiency. Work Arrangement: - Hybrid - The associate is required to work onsite at the Baton Rouge, Louisiana office four (4) days...
Location:
Baton Rouge, LA
Job Type:
Full-Time
Permanent
Occupation:
Medical and Health Services Managers
Career Level / Education:
Bachelor's degree
Salary:
High Income Jobs ($80K-$99K)
From:
AmeriHealth Caritas
Certifications / Licenses:
Driver's License
Advanced Certification Administrator
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Finance Director

AmeriHealth Caritas
New Hampshire
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Role Overview: The Finance Director oversees all accounting and financial ...
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Summary
About the job:
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: - Hybrid - This role requires the associate to be onsite at the Manchester, New Hampshire (NH) office at least three days per week, including mandatory in-office days on Tuesdays and Wednesdays. Responsibilities: - Lead the development and...
Location:
New Hampshire
Job Type:
Full-Time
Permanent
Occupation:
Accountants and Auditors
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
From:
AmeriHealth Caritas
Certifications / Licenses:
Certified Public Accountant
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Manager Provider Network Management

AmeriHealth Caritas
Detroit, MI
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Role Overview: The Manager of Provider Network Management oversees the ...
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Summary
About the job:
day-to-day operations of the Network Management department, including staff supervision, provider contracting, recruitment, and compliance. This role ensures the provider network meets regulatory standards and supports the healthcare needs of plan members. The manager also leads initiatives to improve provider satisfaction, streamline processes, and enhance electronic strategies for claims and auto-adjudication. Work Arrangement: - Hybrid -This role requires the associate to be onsite at the Southfield, Michigan (MI)...
Location:
Detroit, 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:
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

Director Service Coordinator Long Term Services & Support

AmeriHealth Caritas
Philadelphia, PA
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Your career starts now. We are looking for the next generation of health ...
Details
Summary
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:
Philadelphia, PA
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:
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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Role Overview: Under the direction of the Manager, Behavioral Health ...
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Summary
About the job:
Utilization Review , the Behavior Health Utilization Management Reviewer (BHR) 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. Work Arrangement: - Remote role. - Monday through Friday from 8:00a ET to 5:00p ET. Responsibilities: Ensures that appropriate services are...
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 Clinical Social Worker
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Behavioral Health Care Manager

AmeriHealth Caritas
Located in Ohio
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data-type="string"> Description : **Role Overview :** The Care Manager ...
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Summary
About the job:
facilitates access to behavioral health, substance use, and intellectual/developmental disabilities therapeutic services, ensuring that every youth receives the right services at the right time as part of an integrated service plan. The Manager makes the timely intensity of service determinations based on the urgency of need, including the management of emergencies, which includes access to mobile response services. **Work Arrangement:** + Remote role. + Monday through Friday from 10am-6:30pm with rotating weekends and...
Location:
Located in Ohio
Job Type:
Full-Time
Permanent
Occupation:
Healthcare Social Workers
Career Level / Education:
Master's degree
Salary:
High Income Jobs ($80K-$99K)
From:
De jobs
Certifications / Licenses:
Licensed marriage and family therapist
Licensed Psychologist
Licensed Clinical Social Worker
Licensed Professional Counselor
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Service Desk Manager

AmeriHealth Caritas
Located in Ohio
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data-type="string"> Description : **Role Overview** The **Service Desk ...
Details
Summary
About the job:
Manager** at AmeriHealth Caritas plays an important role to the organization, as it serves as the single point of contact for all queries and issues reported by our associates. The Service Desk is responsible for effectively managing customer expectations, setting the organizational standard for customer engagement, serving as the communication channel between customers and the IT organization and, as much as possible, providing a first-contact resolution. In this role you will manage an offshore Service Desk model and...
Location:
Located in Ohio
Job Type:
Full-Time
Permanent
Occupation:
Computer User Support Specialists
Career Level / Education:
Some college, no 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

Behavioral Health Utilization Management Reviewer

AmeriHealth Caritas
Located in Ohio
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data-type="string"> Description : **Role Overview:;** Under the direction of ...
Details
Summary
About the job:
the Supervisor, the Behavioral Health Utilization Management 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...
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

Pediatric Care Manager

AmeriHealth Caritas
Located in Ohio
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data-type="string"> Description : **Role Overview** The Care Manager II ...
Details
Summary
About the job:
supports members in achieving optimal health through self-management. Engaging with members, caregivers, and providers, the role involves assessing plans, setting individual goals, and coordinating care to ensure quality and cost-effective resources. This position serves as a single point of contact and advocates for care coordination program members, overseeing care management activities within assigned practices to meet Plan, NCQA, and Federal/State standards. **Work Arrangement:** Remote- Must reside in PA or have 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:
Associate Degree in Nursing
National Committee for Quality Assurance
Certified Registered Nurse
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Director Service Coordinator Long Term Services & Support

AmeriHealth Caritas
Located in Ohio
Actions
Apply
Save to My Profile
See all jobs from this company
See who you know on LinkedIn
Report this job
data-type="string"> Description : Your career starts now. We are looking for ...
Details
Summary
About the job:
the next generation of health 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...
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
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