Manager Claims

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 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 hear you.
Headquartered in Newtown Square, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver 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 administrative services.
Discover more about us at www.amerihealthcaritas.com.
Responsibilities:
The Manager of Claims is responsible for the coordination of all operational ; activities related to the Claims Unit (claims processing, provider claims services, research and projects). Manages the activities of the department. ;Ensures that priorities/tasks are completed on time. Identifies and resolves operational issues using well-defined/documented processes, expertise and judgment. Ensures that performance standards are met in accordance with the (SLA). ;Coaches team to meet and/or exceed performance goals. ;Measures performance and makes promotional and disciplinary decisions. Assists in the development of a consolidated operating budget. ;Makes efforts to control costs while seeking ways to increase productivity, improve quality and enhance revenue. Hiring responsibility for operations associates. ;Provides career/professional development to new and existing team members. Keeps abreast of new developments in area(s) of responsibility and ensures timely communication to the team. Responsible for internal and customer-initiated audits, regulatory reviews and customer certifications (HEDIS and NCQA). ;Manages operational programs to provide information necessary to improve production. ;Works with Work Force Management to ensure staffing allocations are managed and assigned based upon production and SLAs.
Education & Experience:

• Bachelor’s Degree;or equivalent work experience required.
• 3+ years’ experience in healthcare, managed care or insurance industry environment required.
• 5+ years of management experience.
• Previous claims management experience required.
  

Diversity, Equity, and Inclusion
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.
We keep our associates happy so they can focus on keeping our members healthy.
Our Comprehensive Benefits Package
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, 401(k) Tuition reimbursement and more.