Edgmont Township, Pennsylvania, United States · Remote OK
TITLE: Developer Programmer Lead (Job ID 434432) LOCATION: Newtown Square, PA (remote work option 100% of the time) DUTIES: Design, develop, test, and implement thoughtful and cost-effective software solutions and applic…
Skills: Microsoft SQL Server, ETL, DataStage, SSIS, .NET Development
Manchester, New Hampshire, United States · Hybrid
Role Overview: We’re seeking a detail-oriented and relationship-driven Account Executive to manage and support our network of contracted healthcare providers. In this role, you’ll build and maintain strong partnerships, …
Skills: Relationship Management, Provider Orientation, Compliance Monitoring, Data Analysis, Credentialing
North Charleston, South Carolina, United States · Hybrid
Work Arrangement: This position requires a South Carolina resident. Will work in our Charleston office once a week. This is a part-time position working 20 / hr week. Job Summary The Part - Time Foster Care Clinical Dire…
Skills: Clinical Leadership, Trauma-Informed Care, Pediatric Medicine, Behavioral Health, Medicaid Managed Care
District of Columbia, United States · Hybrid
$92k–$126k/yr
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 Analysis, Quality Improvement, HEDIS, CAHPS, NCQA Accreditation
Edgmont Township, Pennsylvania, United States · Hybrid
THIS IS A HYBRID, OFFICE BASED POSITION WORKING AT OUR ELLIS PRESERVE OFFICE LOCATED IN NEWTOWN SQUARE, PA. WE WILL NOT CONSIDER REMOTE CANDIDATES! Role Overview The Senior Azure Data Engineer designs, builds, and optimi…
Skills: Azure Data Factory, Azure Databricks, PySpark, SQL, Snowflake
Lower Paxton Township, Pennsylvania, United States · Hybrid
Role Overview 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 wil…
Skills: Case Management, Needs Assessment, Care Coordination, MS Office, Excel
Southfield, Michigan, United States · Hybrid
Role Overview: The Performance Practice Advisor supports the Provider Network Management (PNM) team within a POD-based staffing care model, focusing on provider performance, value-based care (VBC) initiatives, and qualit…
Skills: Provider Performance Analysis, Value-Based Care, HEDIS, TCOC Analysis, MLR Analysis
United States · Remote OK
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: Proposal Writing, Technical Writing, Medicaid Managed Care, People Management, Editing
United States · Remote OK
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: Proposal Writing, Technical Writing, Scenario Writing, Medicaid Managed Care, Editing
Robbinsville Township, New Jersey, United States · Hybrid
$145k–$198k/yr
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: Team Leadership, Agile SDLC, Full Stack Development, .NET, Angular
Scranton, Pennsylvania, United States · Remote OK
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, MS Office, Excel
United States · Remote Solely
Role Overview: The Supervisor, Integrated Care Management, provides clinical leadership and operational oversight for the Care Management team, ensuring the effective delivery of care coordination, case management, and s…
Skills: Clinical Leadership, Case Management, Care Coordination, Staff Supervision, Regulatory Compliance
Edgmont Township, Pennsylvania, United States · Hybrid
Role Overview: This position provides support to counsel within the Legal department on general and specific legal matters. It works with others as part of a team to prepare and review exhibits and other documentation fo…
Skills: Litigation Management, Calendar Management, Legal Documentation, Case Management Systems, Microsoft Office
United States · Remote OK
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: Regulatory Counseling, Legal Risk Assessment, Exchange Marketplace Knowledge, Managed Care Law, Strategic Business Partnership
Pittsburgh, Pennsylvania, United States · Remote OK
Role Overview 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 wil…
Skills: Case Management, Needs Assessment, Care Coordination, MS Office, Excel
Wilmington, Delaware, United States · Hybrid
Your career starts now. We are looking for the next generation of health care leaders. At AmeriHealth Caritas, we are passionate about helping people get care, stay well and build healthy communities. As one of the natio…
Skills: Case Management, Clinical Assessment, Care Planning, Patient Advocacy, Medication Reconciliation
United States · Remote OK
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: Portfolio Management, Corporate Planning, Strategic Planning, Financial Analysis, Business Case Development
Edgmont Township, Pennsylvania, United States · Hybrid
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, Reference Data Management, Azure Cloud Services, Informatica MDM, Reltio
Edgmont Township, Pennsylvania, United States · Hybrid
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: Enterprise Portfolio Management, Strategic Planning, Investment Roadmap Planning, Intake Management, Value Realization
United States · Remote OK
Role Overview The Behavioral Health Coordinator serves as a liaison between the Delaware Division of Medicaid and Medical Assistance (DMMA), the Case Management Team, the Division of Substance Abuse and Mental Health (DS…
Skills: Care Coordination, Behavioral Health, Case Management, Outreach, Documentation
Edgmont Township, Pennsylvania, United States • Remote OK
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Design, develop, and implement cost-effective software solutions and applications using SQL Server and ETL tools to support Medicare operations. Interface with stakeholders to translate business requirements into technical specifications and maintain system architecture.
Requires a Bachelor's degree in Computer Science or a related field with at least 5 years of experience in Trizetto Elements, FACETS, and SQL/Oracle development. Must also possess 3 years of experience in healthcare IT solutions for regulatory compliance and production.
TITLE: Developer Programmer Lead (Job ID 434432)
LOCATION: Newtown Square, PA (remote work option 100% of the time)
Design, develop, test, and implement thoughtful and cost-effective software solutions and applications in support of AmeriHealth Caritas Medicare organization using Microsoft SQL Server (stored procedures, triggers and functions) and ETL tools such as DataStage or SSIS. Troubleshoot and solve design and coding problems and interpret business requirements and functional specifications in the delivery of software solutions. Interface with internal stakeholders and business clients to understand our business needs and design solutions. Provide input related to the technical design of new applications/systems and architecture, and configure and develop new applications, including tuning, optimization and .NET development. Conduct Oracle & Sybase development. Use Tidal, file management software and SDLC processes to produce solutions. Compose technical and non-technical documents, including functional specifications, technical design specifications, and other technical schematics, within defined architecture, utilizing standard procedures and techniques. Analyze data and process flows in the work of developing a solution or supporting applications. Contribute to feasibility analyses, resource and cost estimations for new systems or incoming tasks. Build and maintain knowledge about the company's processes and strategies and promote integration across systems including applications outside of Medicare. Liaise with Cognizant Trizetto Elements/FACETS Product Support personnel and communicate effectively with infrastructure and technical resources to ensure uninterrupted processing. Navigate job scheduler and in-house ticketing systems to support daily processing and monitoring. Remote work option 100% of the time.
Bachelor’s degree (or foreign equivalent) in Computer Science, Information Technology, Computer Engineering, or a related field. Must have 5 years of experience with the following: Working with Trizetto Elements including Enrollment Administration Manager (EAM) and Trizetto Solutions Adaptor, FACETS Legacy Batch Processing [Member Maintenance Subsystem (MMS) Keyword File Ingestion] EAM/FACETS Event Driven [Realtime] Processing end to end support of Facets batches and data issues; Using MS SQL and Oracle to review, create and troubleshoot break fixes and enhancements for custom processes, performance tuning for long running queries in SQL server, development of custom scripts and stored procedures to correct or extract data, and development of custom reports to support business requirements in Sybase; Using Windows administration, Unix and DOS commands, IIS configuration, SSL certificates and Facets eXtended Interface (FXI) broker configuration to navigate servers, transfer and deploy files for server maintenance and support; and Working with Tidal and Service Now to leverage understanding and commands to navigate job scheduler and in-house ticketing systems. Must have 3 years of experience with the following: Healthcare experience with analysis, design, development, testing, documentation and support of tailored IT solutions for regulatory compliance, growth, and production in healthcare operations. Remote work option 100% of the time.
Our mission at AmeriHealth Caritas New Hampshire is to help people: Get care. Stay well. Build healthy communities.
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
Our mission at AmeriHealth Caritas New Hampshire is to help people: Get care. Stay well. Build healthy communities.
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