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Results based on filters ( 83 jobs found )

Behavioral Health Care Manager

Keystone First
Located in Ohio
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Role Overview : The PerformCare-PA Behavioral Health Clinical Care Manager ...
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Summary
About the job:
is a core participant of the collaborative care team, including the member/family, behavioral health providers, behavioral health service system, and Physical Health (PH)-Managed. Care Organization (MCO) and medical providers, when applicable, as well as the larger primary care team. The Behavioral Health Care Manager is responsible for providing utilization management and both case and care management, as well as supporting and coordinating the behavioral healthcare of members per assigned caseload, with the...
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:
Keystone First
Certifications / Licenses:
Licensed marriage and family therapist
Licensed Social Worker
Licensed Clinical Social Worker
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
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Detailed Job Information

Personal Care Connector

Keystone First
Philadelphia, PA
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Your career starts now. We’re looking for the next generation of health care ...
Details
Summary
About the job:
leaders. At AmeriHealth Caritas, we’re 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’d like to hear...
Location:
Philadelphia, PA
Job Type:
Full-Time
Permanent
Occupation:
Customer Service Representatives
Career Level / Education:
High school diploma or equivalent
Salary:
Upper Middle Income Jobs ($50K-$79K)
From:
Keystone First
Certifications / Licenses:
N/A
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Developer Programmer Lead

Keystone First
Newtown Square, PA
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TITLE: Developer Programmer Lead (Job ID 433318) LOCATION: Newtown Square, ...
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Summary
About the job:
PA (remote work option 100% of the time) DUTIES: Analyze, design, develop, test, and implement cost-effective software solutions and applications using MS SQL Server, .Net technologies. Use knowledge of application development methods including Agile and Waterfall to produce deliverables. Contribute to Detail Design Sessions and Code Reviews. Troubleshoot and solve design and coding problems by providing first/second level troubleshooting and technical and operational support with limited guidance. Translate business,...
Location:
Newtown Square, PA
Job Type:
Full-Time
Permanent
Occupation:
Software Developers
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
From:
Keystone First
Certifications / Licenses:
N/A
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Application Architect

Keystone First
Newtown Square, PA
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TITLE: Application Architect (Job ID 434013) LOCATION: Newtown Square, PA ...
Details
Summary
About the job:
(remote work option 100% of the time) DUTIES: Develop, configure, code and test programs from specifications using SQL/SQL Server, .Net, and SSIS technologies. Interface with business analysts, project managers and clients to translate and clarify business, technical requirements. Contribute to technical design, the testing of her own work, and to the development of test plans throughout the Software Development Life Cycle (“SDLC”) using modular code development, tuning and optimization. Maintain awareness of...
Location:
Newtown Square, PA
Job Type:
Full-Time
Permanent
Occupation:
Software Developers
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
From:
Keystone First
Certifications / Licenses:
N/A
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Actuarial Analyst

Keystone First
Newtown Square, PA
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This role is hybrid and requires 3 days/week in the office in Newtown ...
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Summary
About the job:
Square, PA. Responsibilities Calculates, monitors and assesses impact of benefit and provider reimbursement changes, cost containment programs, on medical cost and trends. Develops and maintains spreadsheets and databases for purposes of trend and data analytics Performs monthly data analysis projects to assist senior analysts Develops forecasting models for re-forecasts and expected budgets Assists in developing cost projections for contact period negotiations. Performs monthly review of outstanding claim liabilities to...
Location:
Newtown Square, PA
Job Type:
Full-Time
Permanent
Occupation:
Actuaries
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
From:
Keystone First
Certifications / Licenses:
Actuarial Exams
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Customer service representative (Bilingual)

Keystone First
Charleston, SC
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Job Description: Under the direct supervision of Operation Supervisors, the ...
Details
Summary
About the job:
Customer Service Representative is responsible for supporting a diverse membership community and their providers as well as other customers in a timely manner. This includes inbound and outbound engagement with members and/or providers via phone calls or correspondence regarding benefits, eligibility, or customer issues. Must be bilingual (English/Spanish) and demonstrate the ability to perform the responsibilities of the position in either English or Spanish language. Responsibilities: - Conduct Welcome Calls to new...
Location:
Charleston, SC
Job Type:
Full-Time
Permanent
Occupation:
Customer Service Representatives
Career Level / Education:
High school diploma or equivalent
Salary:
Middle Income Jobs ($30K-$49K)
From:
Keystone First
Certifications / Licenses:
N/A
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Clinical Program Management Analyst

Keystone First
Located in Ohio
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Your career starts now. We’re looking for the next generation of health care ...
Details
Summary
About the job:
leaders. At AmeriHealth Caritas, we’re 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’d like to hear...
Location:
Located in Ohio
Job Type:
Full-Time
Permanent
Occupation:
Pharmacists
Career Level / Education:
Doctoral or professional degree
Salary:
Six Figure Jobs (more than $100K)
From:
Keystone First
Certifications / Licenses:
National Pharmacy Technician
National Healthcareer Association
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Medical Director Utilization Management

Keystone First
Located in Ohio
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The Medical Director, Utilization Management, provides organizational ...
Details
Summary
About the job:
leadership in the operational areas of appeals, utilization review, quality improvement, and related policy and practice initiatives in collaboration with the Corporate Medical Director(s), Utilization Management, and the Vice President, Medical Affairs. The following responsibilities are regarding enrollees with medical conditions and their providers: Identifying and implementing evidence-based practice guidelines throughout the provider network. Overseeing the quality of clinical care for network and non-network...
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:
Keystone First
Certifications / Licenses:
N/A
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Senior Creative Project Manager

Keystone First
Newtown Square, PA
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Job Summary The Senior Creative Project Manager is responsible for managing ...
Details
Summary
About the job:
the end-to-end lifecycle of complex, large-scale creative projects for AmeriHealth Caritas’ in-house creative agency. This role is tasked with overseeing ambiguous, cross-functional, multi-channel, integrated creative campaigns and requires a strategic thinker with a deep understanding of creative project management methodology, exceptional organizational skills, and the ability to navigate uncertainty. The ideal candidate will function as the primary point of contact for stakeholder’s post creative kickoff and...
Location:
Newtown Square, PA
Job Type:
Full-Time
Permanent
Occupation:
Project Management Specialists
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
From:
Keystone First
Certifications / Licenses:
N/A
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Provider Network Account Executive I

Keystone First
Located in Ohio
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Job Description: As a Community Health Choices (CHC) Provider Network ...
Details
Summary
About the job:
Account Executive, you will play a vital role in building and nurturing those connections. In this position, you’ll serve as a trusted partner to a diverse portfolio of healthcare providers—including solo practitioners, multi-site groups, and integrated delivery systems—ensuring they have the support and resources needed to deliver exceptional care to our members. Responsibilities Serve as the primary liaison between the Plan and assigned providers, ensuring a thorough understanding of contract terms, provider needs, and...
Location:
Located in Ohio
Job Type:
Full-Time
Permanent
Occupation:
Patient Representatives
Career Level / Education:
Postsecondary nondegree award
Salary:
Middle Income Jobs ($30K-$49K)
From:
Keystone First
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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