Coord Disability Advocacy Prog

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 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. 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.

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:

Responsible for the preparation of case management files for assigned Plan members who are eligible to receive Supplemental Security Income (SSI) or CSHCS benefits and the creation and maintenance of case management documentation in the CSHCS/SSI database.  Coordinates with the Manager of the DAP and the UM associates to receive monthly data loads and distribute member data to UM for process of renewals.  Coordinates and facilitates the CSHCS/SSI conversion application process by working closely with member, providers, Utilization Management (UM), and the local Medicaid office (MC), as needed.  Coordinates with UM to contact members and/or process mailings to Plan members identified as eligible for renewal in the CSHCS/SSI program.  Maintains relationship and works with providers to facilitate the exchange of medical documentation regarding specialty treatment received for designated chronic medical conditions.  Work involves frequent contact with members, medical services, government services, providers and others to obtain and verify medical and financial information needed to determine SSI/CSHCS eligibility. 

Education/ Experience:

• High School Diploma/GED required.
• Associate’s Degree preferred.
• 3 to 5 years managed care experience.

Other Skills: 

• Knowledge of medical terminology & medical records procedures.
• Knowledge of Facets, Jiva, EXP, RightFax, MS Office.
• Knowledge of referral procedures for case management, including state requirements regarding case management.
• Knowledge of Children’s Special Health Care Services program and/or medical claims processing in a disability determination service office or related experience preferred.
• Ability to identify and utilize cultural and community resources useful.

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.