Candidates must live in Elk, McKean, Potter, or Cameron Counties in PA and be able to travel to surrounding areas. Role Overview AmeriHealth Caritas is seeking service-oriented, compassionate healthcare professionals to …
Skills: Case Management, Needs Assessment, Care Coordination, Participant-Centered Planning, Medicaid Knowledge
Market President, Keystone First/AmeriHealth Caritas PA
Tinicum Township, Pennsylvania, United States · Hybrid
Senior+
Your career starts now. We’re looking for the next generation of health care leaders. At AmeriHealth Caritas, we’re passionate about helping people get care, stay well and build healthy communities. As one of the nation'…
Skills: Strategic Direction, Operational Management, Medical Affairs, Quality Assurance, Marketing
For roles that are 100% remote or hybrid, you must have access to a reliable high-speed internet connection to support daily job responsibilities. A minimum bandwidth of 50 Mbps download and 5 Mbps upload is required. Th…
Skills: Product Management, Data Analytics, SQL, Databricks, Azure DevOps
Role Overview: AmeriHealth Caritas New Hampshire (ACNH) is seeking a passionate and community-driven Community Educator to join our outreach team and help connect vulnerable and diverse populations across the state to es…
Skills: Communication, Public Speaking, Interpersonal Skills, Customer Service, Event Planning
North Charleston, South Carolina, United States · Remote OK
Senior
Work Arrangement: This position is a remote field based position. Must reside in South Carolina. Will make provider visits throughout the state. Job Summary The primary responsibility of the Network Contractor is contrac…
Skills: Contract Negotiation, Provider Network Management, Financial Acumen, Reimbursement Methodologies, Value Based Contracting
Tinicum Township, Pennsylvania, United States · Remote OK
Mid level
For roles that are 100% remote or hybrid, you must have access to a reliable high-speed internet connection to support daily job responsibilities. A minimum bandwidth of 50 Mbps download and 5 Mbps upload is required. Th…
Skills: Print Production, Mail Merge, PDF Conversion, Quality Control, Pitney Bowes Equipment
For roles that are 100% remote or hybrid, you must have access to a reliable high-speed internet connection to support daily job responsibilities. A minimum bandwidth of 50 Mbps download and 5 Mbps upload is required. Th…
Lancaster County, South Carolina, United States · Hybrid
Mid level
Role Overview: Care Manager II (Field-Based, Remote) Responsible for managing and coordinating care, services, and social determinants of health for Members with acute, chronic, medically complex, and behavioral health c…
Skills: Care Coordination, Clinical Assessment, Case Management, Behavioral Health, Patient Education
North Charleston, South Carolina, United States · Remote OK
Senior
Work Arrangement: This position is a remote field based position. Must reside in South Carolina. Will be required make provider visits throughout the state. Job Summary The Performance Practice Advisor, is part of the PO…
For roles that are 100% remote or hybrid, you must have access to a reliable high-speed internet connection to support daily job responsibilities. A minimum bandwidth of 50 Mbps download and 5 Mbps upload is required. Th…
Skills: Clinical Appeals Review, Medical Record Review, InterQual Criteria, Medical Necessity Determination, Regulatory Compliance
Edgmont Township, Pennsylvania, United States · Hybrid
Senior+
For roles that are 100% remote or hybrid, you must have access to a reliable high-speed internet connection to support daily job responsibilities. A minimum bandwidth of 50 Mbps download and 5 Mbps upload is required. Th…
Skills: Data Governance, Data Quality, Change Management, Strategic Roadmapping, Data Taxonomy
For roles that are 100% remote or hybrid, you must have access to a reliable high-speed internet connection to support daily job responsibilities. A minimum bandwidth of 50 Mbps download and 5 Mbps upload is required. Th…
Skills: Azure Databricks, MS SQL Server, MS Power BI, Excel Data Models, SQL
Edgmont Township, Pennsylvania, United States · Remote OK
Senior
For roles that are 100% remote or hybrid, you must have access to a reliable high-speed internet connection to support daily job responsibilities. A minimum bandwidth of 50 Mbps download and 5 Mbps upload is required. Th…
Skills: Master Data Management, Enterprise Reference Data Management, SQL, Databricks, Informatica
Edgmont Township, Pennsylvania, United States · Hybrid
Senior+
For roles that are 100% remote or hybrid, you must have access to a reliable high-speed internet connection to support daily job responsibilities. A minimum bandwidth of 50 Mbps download and 5 Mbps upload is required. Th…
Skills: Data Architecture, Healthcare Interoperability, FHIR, HL7, SQL
For roles that are 100% remote or hybrid, you must have access to a reliable high-speed internet connection to support daily job responsibilities. A minimum bandwidth of 50 Mbps download and 5 Mbps upload is required. Th…
Skills: Managed Care, Health Plan Operations, Healthcare Delivery, Government-sponsored Healthcare Programs, Medicaid Strategy
Clearfield, Pennsylvania, United States · Remote OK
Mid level
Role Overview AmeriHealth Caritas is seeking service-oriented, compassionate healthcare professionals to join our Long Term Services and Support (LTSS) team.Ideal candidates will have experience assessing those needingpe…
Skills: Case Management, Needs Assessment, Care Coordination, Participant-Centered Planning, MS Office
For roles that are 100% remote or hybrid, you must have access to a reliable high-speed internet connection to support daily job responsibilities. A minimum bandwidth of 50 Mbps download and 5 Mbps upload is required. Th…
Skills: Case Management, Medical Terminology, Benefit Interpretation, Regulatory Compliance, Microsoft Office Suite
For roles that are 100% remote or hybrid, you must have access to a reliable high-speed internet connection to support daily job responsibilities. A minimum bandwidth of 50 Mbps download and 5 Mbps upload is required. Th…
Skills: Actuarial Modeling, Rate Advocacy, Financial Forecasting, Data Mining, Excel
Manchester, New Hampshire, United States · Remote OK
Senior
Role Overview: The Senior Clinical Quality Performance Specialist is responsible for overseeing, designing, and implementing quality initiatives, identifying root causes, establishing and executing work plans to implemen…
Skills: Data Analysis, Quality Improvement, HEDIS, CAHPS, NCQA Accreditation
Role Overview: The Manager, Behavioral Health Clinical Liaison, is responsible for supporting the development, implementation, and monitoring of programs that promote whole-person integrated physical and behavioral healt…
Skills: Behavioral Health Integration, Clinical Operations, Care Coordination, Program Development, Stakeholder Management
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Full-time
bachelor degree
Flexible work solutions, Competitive pay, Paid time off, Holidays, Volunteer events, Health insurance
Posted 3d ago
~40 hrs/week
Responsibilities
Coordinate long-term services and supports for Medicaid participants through face-to-face assessments and participant-centered planning. Manage the delivery of physical, behavioral, and social services while assisting participants with eligibility and grievance processes.
Requirements
Requires a Bachelor's degree in social work or psychology, or 3+ years of related social service experience, plus 2-3 years of case management. Must possess a valid driver's license, reliable transportation, and computer proficiency in MS Office.
Full job description
Candidates must live in Elk, McKean, Potter, or Cameron Counties in PA and be able to travel to surrounding areas.
Role Overview
AmeriHealth Caritas is seeking service-oriented, compassionate healthcare professionals to join our Long Term Services and Support (LTSS) team.Ideal candidates will have experience assessing those needingpersonal care services for instrumental daily living activities. As a Service Coordinator, you will assist participants who qualify for Medicaid in obtaining the long-term services and support they need as required by the Community Health Choices (CHC) agreement. You will contribute to the care coordination process by performing face-to-face assessments to identify, evaluate, coordinate, and manage participant's needs, including physical health, behavioral health, social services, and long-term services and support, as well as telephonic follow-up.
Work Arrangement
This role is remote and will be community-facing
Candidates must live in Elk, McKean, Potter, or Cameron Counties in PA and be able to travel to surrounding areas.
Responsibilities
Identify, coordinate, and assist participants in accessing needed LTSS services and other Covered Services, as well as non-covered medical, social, housing, educational, and other services and supports
Lead the participant-centered planning and service (PCPS) delivery process and oversee its implementation
Inform participants about available required needs assessments, the PCSP process, service alternatives, and service delivery options
Informs participants of their rights and assists with the complaint, grievance, and DHS Fair Hearing process
Collect additional necessary information, including participant preferences, strengths, and goals, to inform the development of the PCSP
Conducts reevaluation of level of care annually or more frequently as needed following CHC requirements
Works with the participant to complete activities necessary to maintain eligibility
Education and Experience
Bachelor’s Degree in social work, psychology, or related field is preferred
3+ years of social service (in lieu of a Bachelor’s degree) or related healthcare experience that required the following:
working with people who need personal care services
conducting face to face visits in the home or nursing facility focused on needs assessments and monitoring delivery of services
knowledge of the home and community-based service system and how to access/arrange for services
maintaining contact and relationships with healthcare professionals on a regular cadence, providing consistent and timely feedback to members' needs and requests
2 to 3 years of Case management experience
Licensure
Valid and current driver’s license with reliable transportation with state-mandated minimum insurance
Skills & Abilities
Must be computer proficient and have a working knowledge of MS Office specifically Excel
High speed internet
Dedicated home workspace free from distractions and conducive to HIPAA and Government compliance regulation
AmeriHealth Caritas is a mission-driven organization with more than 40 years of experience delivering comprehensive, outcomes-driven care to those who need it most. We are 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.
We'd like to hear from you if you want to make a difference in people’s lives.
Our Comprehensive Benefits Package
Flexible work solutions, including remote options and hybrid work schedules, Competitive pay, Paid time off, including holidays and volunteer events, Health insurance coverage for you and your dependents on Day 1, 401(k) Tuition reimbursement, and more.
#HM
Related keywords
LTSSCommunity Health ChoicesCHCMedicaidCase ManagementSocial WorkHealthcareNeeds AssessmentPCSPHIPAAHome and Community-Based ServicesPatient Care
Our mission at AmeriHealth Caritas New Hampshire is to help people:
Get care.
Stay well.
Build healthy communities.
Industry
Hospitals and Health Care
Company size
51-200 employees
Headquarters
Manchester, New Hampshire
LinkedIn followers
268
At AmeriHealth Caritas New Hampshire, we're passionate about helping people get care, stay well, and build healthy communities. We are located in Manchester, NH and serve Medicaid recipients throughout the entire state of New Hampshire.
AmeriHealth Caritas New Hampshire is part of the AmeriHealth Caritas Family of Companies. Headquartered in Philadelphia, AmeriHealth Caritas is a mission-driven organization with more than 35 years of experience delivering comprehensive, outcomes-driven 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 support services. In the process, we are dedicated to helping find solutions to end poverty so the American Dream is in reach for all.
Offices: 25 Sundial Ave, 1st Floor, Manchester, New Hampshire 03103, US
healthcaremedicaidhealth insurancepublic healthand new hampshire
Our mission at AmeriHealth Caritas New Hampshire is to help people:
Get care.
Stay well.
Build healthy communities.
Industry
Hospitals and Health Care
Company size
51-200 employees
Headquarters
Manchester, New Hampshire
LinkedIn followers
268
At AmeriHealth Caritas New Hampshire, we're passionate about helping people get care, stay well, and build healthy communities. We are located in Manchester, NH and serve Medicaid recipients throughout the entire state of New Hampshire.
AmeriHealth Caritas New Hampshire is part of the AmeriHealth Caritas Family of Companies. Headquartered in Philadelphia, AmeriHealth Caritas is a mission-driven organization with more than 35 years of experience delivering comprehensive, outcomes-driven 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 support services. In the process, we are dedicated to helping find solutions to end poverty so the American Dream is in reach for all.
Offices: 25 Sundial Ave, 1st Floor, Manchester, New Hampshire 03103, US
healthcaremedicaidhealth insurancepublic healthand new hampshire