Responsibiities:. The Diversity, Equity & Inclusion Data Analyst position will support the planning, coordination, and management of various analytical and research projects as they relate to Amerihealth Caritas’ diversity, equity, and inclusion strategy and initiatives across our governance, workforce, procurement, programming , and community investment focus areas, and partner with analysts in other areas where the Company is driving Divesity, Equity & Inclusion (DE&I) initiatives.. Perform technical and analytical work for the company’s Diversity, Equity & Inclusion (DE&I) programs involvin... view job details
Responsibilities:. Under the oversight and direction of Accounting management and the Senior Accountants, the Accountant is responsible for maintaining the general ledger and preparing supporting schedules/reconciliations. Responsibilities including, but not limited to:. Preparing all assigned journal entries in accordance with current financial standards and as required to accurately present financial activity in the general ledger. Preparing, reviewing, and analyzing all relevant, assigned, schedules (financial analysis package) supporting the financial statements. Reconciling all assigned ... view job details
Responsibilities:. Reporting to the Director, Enterprise Accreditation Programs and the Director, Quality Management, the Accreditation Specialist will serve as a business analyst to ensure system and process compliance with NCQA accreditation standards for all health plans. This position will also assist with preparation of documents and survey process to enable successful accreditation reviews. The position will monitor and establish a catalogue process for medical management policies for the assigned line of business. Interfaces with all departments to ensure process compliance and execut... view job details
Responsibilities:. Develop health care cost trend analytics as part of a dynamic team. Build, deploy and maintain dashboards and analyses that support identification of meaningful medical and pharmacy cost trends. Collaborate with subject matter experts to identify root causes of trends. Work with markets and corporate functions to identify potential medical cost containment initiatives to manage MLR and develop tracking tools to identify realized vs expected savings targets. Develop provider contracting tools and methodologies to support network teams – familiarity with value based contra... view job details
This position is responsible for performing administrative tasks such as. calendar scheduling,. entering data, compiling reports, assembling binders, building spreadsheets, distributing correspondence, recording and dispensing meeting minutes,. travel arrangements, expenses,. and making copies. In addition, this individual is tasked with creating presentations, updating manuals and coordinating mass mailings. We are seeking someone with heavy Outlook calendar scheduling experience and strong Excel and PowerPoint skills. Education Experience:. High School/GED. Associate’s Degree - preferred. ... view job details
Reporting through the Associate Services Manager in Health Services (HS), the Administrative Assistant II will provide specialized and complex administrative activities in support of the Health Services Director(s), as well as ongoing support of all functional areas led by the Health Services Associate Services Director. Responsibilities include providing critical support through research, analysis, and writing, information coordination, distributing correspondence, scribing, distributing meeting minutes, relationship management and assisting the HS Associate Services Manager as needed with m... view job details
Responsibilities:. Coordinates information and data exchange between Medical Management and Community Outreach Solutions Specialists/management team, evaluating resolution priority, urgency of issue, and appropriate stakeholders for resolution. Tracks and inputs data from ongoing member programs, using thorough understanding of each program’s goals, process, timeframes and status to determine accuracy and validity of data. Independently resolves accuracy/validity issues with appropriate stakeholders and management team. Provides support at Marketing events, in addition to or in place of e... view job details
Responsibilities:. Under the general supervision of the Supervisor Appeals & Grievances, the Appeals Administrator assists Intake Coordinator, Coordinator Appeals and Grievances with administrative tasks, including, but not limited to, fax management (storage and distribution), letter processing and storage, data collection and assembling/filing completed appeals folders. Work in-office daily to process all appeals mail. Follow-up with members and providers regarding consent and educating on process. Receives and saves, on a department-wide basis, incoming faxes from the electronic fax system ... view job details
Responsibilities. :. The primary purpose of the job is to: Under the general supervision of the Director of Appeals and Grievances, this position screens calls from members and providers regarding the Part C, Part D and Medicare-Medicaid Plan appeals and grievances processes. In addition, the Coordinator will be responsible for retrieving grievances and appeals from the Customer Service database. This position will be located in our Philadelphia main campus office and will support the appeals and grievances needs of our Medicare Advantage D-SNP and MMP membership. The Appeals and Grievances C... view job details
Responsibilities:. Under the direction of the Manager of Appeals, the Appeal Transcriptionist is responsible and accountable for transcribing all Appeals meeting accurately and within 5 business days of meeting. The Transcriptionist is responsible for maintaining PHI, ensuring that all records are accurate and uploaded to the member’s record. Also provides general administrative support of the team as needed. Listen to the recorded dictation of a doctor or other healthcare professional. Transcribe and interpret the dictation of the Appeals panel meeting and upload to the Member record. Review ... view job details