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Resource Coordinator II

Keystone First
Dover, DE
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Job Description: As part of the care coordination team, the Resource ...
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Summary
About the job:
Coordinator develops and executes outreach strategies within a designated territory to improve health outcomes and enhance member engagement. This role serves as a single point of contact and advocate for members identified as low-risk who have opted out of care coordination but require additional monitoring. The position fosters relationships with members, community stakeholders, and providers. Responsibilities: - Provide support to low-risk maternity members following emergency department visits and/or acute care episodes...
Location:
Dover, DE
Job Type:
Full-Time
Permanent
Occupation:
Healthcare Social Workers
Career Level / Education:
Master's degree
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
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Director of Communications & Marketing

Keystone First
Southfield, MI
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Role Overview: The Director of Communications and Marketing is responsible ...
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About the job:
for developing and executing marketing and communications strategies for the Blue Cross Complete (BCC) of Michigan health plan, ensuring alignment with enterprise standards while tailoring initiatives to meet market-specific needs. Working closely with Corporate Communications Shared Services, internal partners, and health plan leadership, the Director will lead efforts to strengthen brand messaging and position the organization favorably among key stakeholders across the state. Work Arrangement: - Hybrid – The...
Location:
Southfield, MI
Job Type:
Full-Time
Permanent
Occupation:
Public Relations 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

Vice President Plan Operations & Administration

Keystone First
Dublin, OH
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Role Overview: The Vice President of Plan Operations & Administration leads ...
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About the job:
operational strategy and execution for the AmeriHealth Caritas Ohio Medicaid plan. Acting as the primary partner to the Market President, this role ensures alignment with enterprise strategic objectives, contractual obligations, and stakeholder priorities. Serving as second-in-command, the VP oversees all aspects of plan infrastructure, driving operational excellence and compliance through collaboration with shared service teams. Work Arrangement: - Hybrid – The associate must be in the office at least three 3 days...
Location:
Dublin, OH
Job Type:
Full-Time
Permanent
Occupation:
General and Operations 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

Information Systems Engineer Lead

Keystone First
Newtown Square, PA
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Role Overview We are seeking a Sterling File Gateway Engineer Lead to join ...
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Summary
About the job:
our team. In this role, you will play a crucial role to d esign and verify the Sterling File Gateway solution meets business and technical requirements and is in compliance with enterprise architecture guidelines, technology standards and methodology. You will m aintain and manage the SFG application design, including but not limited to monitoring performance and capacity metrics, Standard Level Objective (SLO) and Standard Level Agreement (SLA), resiliency and disaster recovery plan for ETS. Work Arrangement - This is...
Location:
Newtown Square, PA
Job Type:
Full-Time
Permanent
Occupation:
Network and Computer Systems Administrators
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

DIRECTOR COMMUNICATIONS & MARKETING

Keystone First
Philadelphia, PA
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Your career starts now. We’re looking for the next generation of health care ...
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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:
Marketing 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

Contract Specialist

Keystone First
Located in Ohio
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Your career starts now. We’re looking for the next generation of healthcare ...
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 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...
Location:
Located in Ohio
Job Type:
Full-Time
Contract
Occupation:
Compliance Officers
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

Utilization Management Technician

Keystone First
Located in Ohio
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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 nations 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:
Located in Ohio
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:
N/A
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

HVO Performance Management Business Analyst Sr

Keystone First
Newtown Square, PA
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Role Overview Healthcare Value Optimization (HVO) is AmeriHealth Caritas’ ...
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Summary
About the job:
enterprise-wide margin improvement program, which delivers value for the organization through improved member experience, health outcomes, and total cost of care. HVO collaborates closely with functional and market leaders, following a rigorous process to identify, validate, implement, and monitor improvement initiatives across unique workstreams. The Performance Management Senior Analyst will support this program in driving value realization across the business through the delivery of initiatives and capabilities. Work...
Location:
Newtown Square, PA
Job Type:
Full-Time
Permanent
Occupation:
Management 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

Director Provider Network Management

Keystone First
Located in Ohio
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Responsibilities: This position is responsible for all hospital, physician ...
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Summary
About the job:
and physician extender network development and management within the state of Florida. This position is also responsible for implementing strategies to improve provider satisfaction. This position will interact with Hospital and Physician Practice Chief Executive Officers, Chief Financial Officers, Directors of Managed Care and other high level executives. Ensures department achieves annual goals and objectives. - Oversees strategic planning, development, and management of the hospital, physician, and...
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:
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

Provider Network Operations Analyst

Keystone First
Charleston, SC
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Role Overview The Operations Analyst is responsible for conducting root ...
Details
Summary
About the job:
cause analysis and developing reports, studies, and data models to monitor the accuracy of benefit interpretation, claim payment, provider contract configuration, eligibility processing, and revenue-generating interfaces for the South Carolina Medicaid line of business. This role involves defining and implementing data modeling tools or reports to routinely assess existing operational processes, including benefit interpretation, claim payment accuracy, system interfaces, and integration. Work Arrangement Remote for South...
Location:
Charleston, SC
Job Type:
Full-Time
Permanent
Occupation:
Operations Research 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
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