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Results based on filters ( 5 jobs found )

FACETS Business Systems Analyst

Keystone First
Located in Ohio
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Role Overview The Facets Configuration Business Systems Analyst analyzes a ...
Details
Summary
About the job:
wide range of FACETS configuration change requests for the purpose of determining the technical scope of the change, the impact on existing system configuration, and ultimately the exact nature of the modifications required to implement the change. The position requires a thorough understanding and knowledge of relational database theory as well as technical testing methodologies. Work Arrangement This is a 100% remote position Responsibilities Serves as a technical consultant to assigned Health Plan(s) in the...
Location:
Located in Ohio
Job Type:
Full-Time
Permanent
Occupation:
Computer Systems 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
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Detailed Job Information

Customer Service Representative

Keystone First
Philadelphia, PA
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MUST LIVE IN OR NEAR PHILADELPHIA, PENNSYLVANIA, TO QUALIFY FOR ...
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Summary
About the job:
CONSIDERATION Responsibilities: Under the direct supervision of the operations supervisor, the customer service representative is responsible for responding to a diverse membership and their providers, as well as other customers, in a timely, professional, and courteous manner. This includes inbound and outbound member and/or provider phone calls or correspondence regarding benefits, eligibility, or customer issues. Makes outreach welcome calls to new members and conducts Health Risk Assessment Surveys as needed. Provides member...
Location:
Philadelphia, PA
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

Provider Claims Service Representative

Keystone First
Philadelphia, PA
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Responsibilities: Under the general direction of the Operations Call Center ...
Details
Summary
About the job:
Supervisor, responsible for responding in a timely, professional and courteous manner to all customer needs. This includes provider phone calls or correspondence regarding benefit, eligibility, and other provider issues. Reviews and adjudicates claims based on provider and healthplan contractual agreements and claims processing guidelines. Serves as a Subject Matter Expert. Conducts cross training to staff as required. Demonstrates solid knowledge of Provider Service/Claim systems, functions and team process....
Location:
Philadelphia, PA
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

Supervisor Service Coordinator

Keystone First
Philadelphia, PA
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Your career starts now. We are looking for the next generation of healthcare ...
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Summary
About the job:
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 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. We want to connect with you if you're going to...
Location:
Philadelphia, PA
Job Type:
Full-Time
Permanent
Occupation:
Healthcare Social Workers
Career Level / Education:
Master's degree
Salary:
Six Figure Jobs (more than $100K)
From:
Keystone First
Certifications / Licenses:
Licensed Social Worker
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Manager Provider Network Management

Keystone First
Washington, DC
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Responsibilities: Responsible for managing the day-to-day activities of the ...
Details
Summary
About the job:
DC Medicaid Plan Network Management department and staff. Responsible for assisting the Leader with departmental activities related to provider satisfaction, education, and communication. This position is also responsible for all provider network recruiting and contracting management activities as it relates to the DC Medicaid Plan. Ensures that the department and staff remain current in all aspects of Federal and State rules, regulations, policies and procedures and creates or modifies departmental policies to...
Location:
Washington, DC
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:
National Committee for Quality Assurance
Advanced Certification Administrator
Driver's License
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information
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