Jobs at Amerihealth Caritas
404,327 open positions
Business System Analyst, Senior
Company: AmeriHealth Caritas
Location: Philadelphia, PA
Posted Mar 20, 2024
AmeriHealth Caritas is seeking passionate individuals to join their team as healthcare business system analysts. The role involves analyzing systems for software solutions, gathering business requirements using Scrum tools, delivering projects using Agile and Scrum frameworks, and troubleshooting Salesforce issues. The ideal candidate should have a Bachelor's degree in Engineering, Computer Science, or a related field, along with 5 years of experience in healthcare business system analysis, data migration, and XML translation. The position offers 100% remote work eligibility.
Business Analyst - Operations - Hybrid
Company: AmeriHealth Caritas
Location: Philadelphia, PA
Posted Mar 16, 2024
AmeriHealth Caritas is a mission-driven organization seeking talented individuals to join their team. They offer comprehensive healthcare solutions and are passionate about helping people get care, stay well, and build healthy communities. The Operations Business Analyst role involves developing solutions to business problems, liaising among stakeholders, and analyzing the organization's needs. The company values diversity, equity, and inclusion, and offers a comprehensive benefits package including flexible work solutions, competitive pay, health insurance, and more.
Director Finance | Hybrid
Company: AmeriHealth Caritas
Location: Detroit, MI
Posted Mar 15, 2024
<p>Your career starts now Were looking for the next generation of health care leaders <p> <p>At AmeriHealth Caritas were 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 awardwinning 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 wed like to hear from you <p> <p>Headquartered in Newtown Square AmeriHealth Caritas is a missiondriven organization with more than 30 years of experience We deliver comprehensive outcomesdriven care to those who need it most We offer integrated managed care products pharmaceutical benefit management and specialty pharmacy services behavioral health services and other administrative services <p> <p>Discover more about us at wwwamerihealthcaritascom <p> <p><strong>Responsibilities<strong> <p> <p>Individual responsible for accounting and finance operations including all audit activities and for the oversight of the day to day financial operations for the health plan or line of business including financial planning reporting and budget management <p> <ul><li>Coordinates the development of the annual operating plan AOP for the health plan or line of business and works with Corporate Finance to ensure timely completion of the AOP <li> <li>Monitors budgetary compliance to assure that operational performance results are achieved <li> <li>Works with Corporate Finance to update reforecasts and the strategic plan as needed <li> <li>Develops and monitors cost containment activities for the LOB <li> <li>Provides information to ensure the production of timely accurate and compliant financial reports that meet all accounting <li> <li>standards government regulations and federal state and local laws<li> <li>Provides ad hoc financial support to senior management middle management and corporate departments as needed<li> <li>Acts as a primary liaison for interactioncommunication with the State Finance personnel as necessary<li> <li>May manage the facilities function for the site<li> <li>May manage one or more of the following staff financial analysts and facility management specialists<li> <ul><p><strong>EducationExperience<strong> <p> <ul><li>Bachelors Degree in Accounting or Finance required<li> <li>CPA preferred<li> <li>Healthcare experience highly preferred<li> <li>35 years management experience<li> <li>7 or more years of FinancialCost Accounting experience<li> <li>Demonstrated understanding of GAAP reporting treasury operations corporate taxation and legal principles<li> <li>Familiarity with healthcare insurance reporting and regulation<li> <li>Demonstrated analytical financial analysis and planning skills<li> <ul><p><b>Diversity Equity and Inclusion<b> <p> <p>At Amerihealth Caritas everyone can feel valued supported and comfortable to be themselves Our commitment to equity means that all associates have a fair opportunity to achieve their full potential We put these principles into action every day by acting with integrity and respect We stand together to speak out against injustice and to break down barriers to support a more inclusive and equitable workplace Celebrating and embracing the diverse thoughts and perspectives that make up our workforce means our company is more vibrant innovative and better able to support the people and communities we serve <p> <p>We keep our associates happy so they can focus on keeping our members healthy <p> <p><b>Our Comprehensive Benefits Package<b> <p> <p>Flexible work solutions including remote options hybrid work schedules Competitive pay Paid time off including holidays and volunteer events Health insurance coverage for you and your dependents on Day 1 401k Tuition reimbursement and more<p>
Grievance Associate
Company: AmeriHealth Caritas
Location: Philadelphia, PA
Posted Mar 11, 2024
<p>Your career starts now We are looking for the next generation of health care leaders <p> <p>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 awardwinning 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 connect with you <p> <p>Headquartered in Newtown Square AmeriHealth Caritas is a missiondriven organization with more than 30 years of experience We deliver comprehensive outcomesdriven care to those who need it most We offer integrated managed care products pharmaceutical benefit management and specialty pharmacy services behavioral health services and other administrative services <p> <p>Discover more about us at wwwamerihealthcaritascom <p> <p><strong>Responsibilities<strong> <p> <p>Working with the Operations Supervisor or Grievance Coordinator the Grievance Associate is responsible for ensuring all problems complaints and grievances presented by Plan members or their representatives are resolved in accordance with established policies and procedures as well as NCQA and FederalState guidelines Under the supervision of the Operations Supervisor or Grievance Coordinator the Grievance Associate acts as a member advocate and communicates with medical facility administrators providers physicians and all applicable AMFC departments to interpret and enhance understanding of the Plans policies and procedures relative to complaints and grievances The Grievance Associate is responsible for accurately documenting in the appropriate computer system all correspondence associated with the grievance The Grievance Associate will thoroughly research questions and issues in order to provide an accurate explanation The Grievance associate tracks and reports turnaround time and keeps abreast of all cases to ensure that the 30day time limit for case resolution is met for 100 of all grievances The associate will provide ComplaintGrievance training for the Plans staff in the base unit and all supporting departments The Grievance Associate will perform other related duties and projects as assigned <p> <p><strong>Education Experience <strong> <p> <ul><li>High SchoolGED <p>Associates Degree preferred<p><li> <li>1 to 3 years previous experience in direct contact with members in relation to any complaints andor grievances<li> <li>Sound knowledge of strong telephone soft skills<li> <li>Prior experience in highly regulated inventory<li> <li>Experience with Contact Center and Workforce Management technology scheduling adherence quality monitoring<li> <li>Excellent Verbal and Written communication skills<li> <li>Microsoft Office skills including Word Excel and Outlook<li> <li>Experience handling escalated calls<li> <li>Demonstrated problemsolving and decision making skills<li> <li>Strong people skills with a focus on mentoring and coaching<li> <li>Ability to work both independently and in a team environment<li> <ul><p><strong>Diversity Equity and Inclusion<strong> <p> <p>At AmeriHealth Caritas everyone can feel valued supported and comfortable to be themselves Our commitment to equity means that all associates have a fair opportunity to achieve their full potential We put these principles into action every day by acting with integrity and respect We stand together to speak out against injustice and to break down barriers to support a more inclusive and equitable workplace Celebrating and embracing the diverse thoughts and perspectives that make up our workforce means our company is more vibrant innovative and better able to support the people and communities we serve <p> <p>We keep our associates happy so they can focus on keeping our members healthy <p> <p><strong>Our Comprehensive Benefits Package<strong> <p> <p>Flexible work solutions including remote options hybrid work schedules Competitive pay Paid time off including holidays and volunteer events Health insurance coverage for you and your dependents on Day 1 401k Tuition reimbursement and more<p>
HSP Team Lead - Remote, USA
Company: AmeriHealth Caritas
Location: Remote
Posted Apr 22, 2024
<p>Your career starts now We are looking for the next generation of healthcare leaders <p> <p>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 awardwinning 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 connect with you <p> <p>Headquartered in Newtown Square AmeriHealth Caritas is a missiondriven organization with more than 30 years of experience We deliver comprehensive outcomesdriven care to those who need it most We offer integrated managed care products pharmaceutical benefit management and specialty pharmacy services behavioral health services and other administrative services <p> <p>Discover more about us at wwwamerihealthcaritascom <p> <p><strong>Description<strong> <p> <p>The Team Leads primary responsibility is supporting the daily claims process Secondarily they are responsible for providing support to the Team Lead Educator as required <p> <p><strong>Responsibilities<strong> <p> <ul><li>Reports to LOB Supervisor<li> <li>Functions as a technical specialist for claims operations<li> <li>Maintains a current working knowledge of LOB processing rules contractual guidelines plan policies and operational procedures<li> <li>Resolves and provides directions to Front End Claims Examiners and Research Analysts regarding complex claims<li> <li>Assists in managing inventory<li> <li>Assists in identifying critical issues with projects and offers solutions<li> <li>Creates and supports an environment that fosters teamwork cooperation respect and diversity<li> <li>Provides technical and peer inservice training including sidebyside training<li> <li>Prepares daily inventory reports<li> <li>Assists Supervisor in assigning work to staff and attends meetings as directed by supervisor or manager<li> <li>Develops and maintains working relationships with multiple functional areas in the Enterprise<li> <li>Participates in OLH Processing Rule Committee<li> <li>Is a knowledgeable Subject Matter Expert of each LOBsupported<li> <li>Supports Claims Team Management Director Manager Supervisor with reports unique processes projects<li> <li>Assists in addressing audit reports and quality review feedback<li> <li>Provides backup support for Team Lead Educator <li> <ul><p><strong>Education amp Experience<strong> <p> <ul><li>Associates or Bachelors Degree<li> <li>Minimum of 4 years of experience in claims processing health and dental claims<li> <li>AC Product amp Claims Knowledge<li> <li>Coordination<li> <li>Excellent Written and Verbal Communication Skills<li> <li>Leadership<li> <li>Strong analytical skills<li> <ul><p><strong>Diversity Equity and Inclusion<strong> <p> <p>At AmeriHealth Caritas everyone can feel valued supported and comfortable to be themselves Our commitment to equity means that all associates have a fair opportunity to achieve their full potential We put these principles into action every day by acting with integrity and respect We stand together to speak out against injustice and to break down barriers to support a more inclusive and equitable workplace Celebrating and embracing the diverse thoughts and perspectives that make up our workforce means our company is more vibrant innovative and better able to support the people and communities we serve <p> <p>We keep our associates happy so they can focus on keeping our members healthy <p> <p><strong>Our Comprehensive Benefits Package<strong> <p> <p>Flexible work solutions include remote options hybrid work schedules competitive pay paid time off holidays and volunteer events health insurance coverage for you and your dependents on Day 1 401k tuition reimbursement and more<p>
Product Submission Lead - Exchange (Remote)
Company: AmeriHealth Caritas
Location: Remote
Posted Mar 28, 2024
AmeriHealth Caritas is seeking a Product Submission Lead to manage the enterprise's qualified health plan (QHP) submission effort. The role involves understanding and complying with state-specific and federal guidelines, coordinating the annual QHP filing process, and working with cross-functional teams. The ideal candidate should have 1-3 years of project management experience, a Bachelor's Degree, and strong organizational and communication skills. AmeriHealth Caratis values diversity, equity, and inclusion, offering comprehensive benefits including flexible work solutions, competitive pay, and health insurance coverage.
Senior Financial Analyst | Remote
Company: AmeriHealth Caritas
Location: Remote
Posted Mar 21, 2024
<p>Your career starts now We are looking for the next generation of health care leaders <p> <p>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 awardwinning 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 connect with you <p> <p>Headquartered in Newtown Square AmeriHealth Caritas is a missiondriven organization with more than 30 years of experience We deliver comprehensive outcomesdriven care to those who need it most We offer integrated managed care products pharmaceutical benefit management and specialty pharmacy services behavioral health services and other administrative services <p> <p>Discover more about us at wwwamerihealthcaritascom <p> <p><strong>Responsibilities<strong> <p> <p>The Senior Financial Analyst is responsible for the compilation and analysis of financial and cost information for the organization The Senior Financial Analyst will support the strategic planning and analysis processes for the Enterprise and will act as liaison for financial data and processes to functional area management at all levels The position will also play a key role in developing financial models for new business opportunities Position will interact with employees at all levels in the organization external clients and vendors <p> <p><strong>Job Responsibilities<strong> <p> <ul><li>Develops financial models to support decision making related to business issues including new product development analysis product portfolio analysis profitability of new opportunities impacts of regulatory changes capital analysis revenue models and profit margin analysis <li> <li>With an emphasis on forecasting analyzes current performance through the creation and monitoring of product metrics and conducts prospective and ongoing economic analysis of products including marketing programs product pricing business initiatives and services<li> <li>Assists in driving change as needed to improve financials for the organization and builds analytical tools to gain efficiencies in financial modeling as required<li> <li>Analyzes and summarizes the divisions financial statements expenses and records Develops recommendations for management decisionmaking<li> <li>Prepares and analyzes the monthly financial statements and reports to produce forecasts of business industry andor economic conditions for use in making sound business decisions Analyzes and reports on the financial impact of current and proposed programs Fulfills complex analysis needs<li> <li>Assists in the development of the longrange financial plans and continuously analyzes operating financial results Works closely with other departments within Amerihealth to ensure that strategic initiatives are achieved<li> <li>May assist in the development of the annual budget and analyzes actual and budgeted figures on an ongoing basis Creates and maintains detailed budgeting templates<li> <li>Reviews monthly financial operating results identifying key trends variances and areas of improved performance Works with other departments for account reconciliation<li> <li>Provides information and assistance to management regarding expenditures purchases and other costs of doing business<li> <li>Performs ad hoc analysis and forecasts for internal management team and external customers<li> <li>Provides guidance and training to associate analysts and recommends best practices on pulling and refining data<li> <li>Develop reports using various database management software primarily Hyperion<li> <ul><p><strong>EducationExperience <strong> <p> <ul><li>Bachelors Degree required Major in Finance Accounting or closely related field <li> <li>Masters or MBA is a plus<li> <li>Minimum five years progressively responsible experience in financial analysis<li> <li>Knowledge of PeopleSoft or other financial systems Hyperion Planning and HFM<li> <li>Advanced knowledge of Excel<li> <li>Experience with financial modeling and strategic planning<li> <ul><p><strong>Diversity Equity and Inclusion <strong> <p> <p>At AmeriHealth Caritas everyone can feel valued supported and comfortable to be themselves Our commitment to equity means that all associates have a fair opportunity to achieve their full potential We put these principles into action every day by acting with integrity and respect We stand together to speak out against injustice and to break down barriers to support a more inclusive and equitable workplace Celebrating and embracing the diverse thoughts and perspectives that make up our workforce means our company is more vibrant innovative and better able to support the people and communities we serve <p> <p>We keep our associates happy so they can focus on keeping our members healthy <p> <p><strong>Our Comprehensive Benefits Package <strong> <p> <p>Flexible work solutions including remote options hybrid work schedules Competitive pay Paid time off including holidays and volunteer events Health insurance coverage for you and your dependents on Day 1 401k Tuition reimbursement and more<p>