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Results based on filters ( 106 jobs found )

RN CARE MANAGER

Keystone First
Columbia, SC
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Role Overview: The Care Manager (BSN - RN) assists members appropriate for ...
Details
Summary
About the job:
care management and care coordination services in achieving their optimal level of health through self-management. The Care Manager (RN) is responsible for engaging the member, member care giver and providers to assess plan and establish individual member goals. Will facilitate and coordinate care for the members while assuring quality and use of cost-effective resources. The position will function as a single point of contact and be an advocate for members in the care management program. In addition, the Care Manager...
Location:
Columbia, SC
Job Type:
Full-Time
Permanent
Occupation:
Registered Nurses
Career Level / Education:
Bachelor's degree
Salary:
High Income Jobs ($80K-$99K)
From:
Keystone First
Certifications / Licenses:
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

Market President, New Hampshire

Keystone First
Manchester, NH
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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:
Manchester, NH
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

Provider Network Data Oversight Analyst

Keystone First
Newtown Square, 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:
Newtown Square, PA
Job Type:
Full-Time
Permanent
Occupation:
Business Intelligence Analysts
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

Utilization Management Reviewer

Keystone First
Located in Ohio
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Role Overview: Under the direction of a supervisor, the Clinical Care ...
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Summary
About the job:
Reviewer – Utilization Management evaluates medical necessity for inpatient and outpatient services, ensuring treatment aligns with clinical guidelines, regulatory requirements, and patient needs. This role requires reviewing provider requests, gathering necessary medical documentation, and making determinations based on clinical criteria. Using professional judgment, the Clinical Care Reviewer assesses the appropriateness of services, identifies care coordination opportunities, and ensures compliance with medical policies....
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:
Certified Registered Nurse
Driver's License
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Care Connector

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:
Healthcare Support Workers, All Other
Career Level / Education:
High school diploma or equivalent
Salary:
Upper Middle Income Jobs ($50K-$79K)
From:
Keystone First
Certifications / Licenses:
Certified Personal Trainer
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Provider Network Operations Data Analyst

Keystone First
Detroit, 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:
Detroit, 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:
Keystone First
Certifications / Licenses:
N/A
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Vice President Provider Network Management

Keystone First
Southfield, MI
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At AmeriHealth Caritas, we’re passionate about helping people get care, stay ...
Details
Summary
About the job:
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. If you want to make a difference, we’d like to hear from you. Headquartered in Newtown Square, AmeriHealth Caritas is a mission-driven...
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:
Keystone First
Certifications / Licenses:
N/A
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Financial Analyst

Keystone First
Detroit, MI
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Role Overview: The Financial Analyst II plays a key role in compiling, ...
Details
Summary
About the job:
analyzing, and interpreting financial data to support the organization’s strategic and operational goals. This position supports enterprise-wide financial analysis efforts and serves as a liaison between functional area management and financial data. The Analyst regularly interacts with employees across all levels of the organization, as well as external clients and vendors, ensuring accurate and insightful financial reporting and collaboration. Work Arrangement: - Hybrid - Associate must be in the office at least two (2)...
Location:
Detroit, MI
Job Type:
Full-Time
Permanent
Occupation:
Financial and Investment Analysts
Career Level / Education:
Bachelor's degree
Salary:
High Income Jobs ($80K-$99K)
From:
Keystone First
Certifications / Licenses:
N/A
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Market Chief Medical Officer

Keystone First
Southfield, MI
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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:
Southfield, MI
Job Type:
Full-Time
Permanent
Occupation:
Medical and Health Services Managers
Career Level / Education:
Bachelor's degree
Salary:
High Income Jobs ($80K-$99K)
From:
Keystone First
Certifications / Licenses:
Advanced Certification Administrator
Driver's License
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

CASE Manager

Keystone First
Detroit, MI
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Role Overview: The Care Manager II is responsible for managing and ...
Details
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 and other health needs. Serves as the primary point of contact for the care team, which includes members, caregivers, physicians, and community supports, to guide members in achieving 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...
Location:
Detroit, MI
Job Type:
Full-Time
Permanent
Occupation:
Registered Nurses
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
From:
Keystone First
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
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