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AHN Saint Vincent jobs
JOB SUMMARY This job ensures that services provided to health plan members and billed by providers to the health plan are submitted to respective State agencies and CMS accurately and timely. Ensures accuracy of complex...
JOB SUMMARY This critical senior leadership role guides a high-performing team of actuarial and analytics professionals, driving strategic, tactical, and operational excellence in claims reserving, financial forecasting,...
JOB SUMMARY This job secures AI/ML, Generative AI, and agentic systems across the enterprise by designing, testing, and operating controls that protect these systems at scale in a regulated healthcare environment. They c...
JOB SUMMARY Providing case mgmt in PA, DE and WV. This job assures that members with complex medical and/or psychosocial needs have access to high quality, cost-effective health care. Assists in the holistic assessment,...
JOB SUMMARY ***CANDIDATE MUST BE US Citizen (due to contractual/access requirements)*** This role is an integral senior member of a technical team, responsible for supporting the design, development, and maintenance of t...
JOB SUMMARY This job serves as the single point of contact for members to coordinate all of the member’s care needs across the various service delivery systems and community supports. This is a full-time community-based...
JOB SUMMARY This job has primary ownership and oversight over a specified panel of members that range in health status/severity and clinical needs. The incumbent assesses health management needs of the assigned member pa...
JOB SUMMARY *This role will be hybrid if you live within a 50 mile radius of one of our offices in (PA, DE, WV or NY) The Senior Payroll Tax Analyst serves as the subject matter expert for payroll tax compliance across a...
JOB SUMMARY This job is responsible for configuring, rolling out, and supporting theEpic ResoluteHospitalBillingand Claims application. Responsibilities include business/systems analysis, requirements definition and docu...
JOB SUMMARY As a Senior Product Manager focused on Payer/Provider Interoperability, this candidate will be a pivotal leader driving the strategic vision and execution for how our products are experienced at the point-of-...
JOB SUMMARY This job is the primary liaison between large/complex provider groups in the Organization network and the corporation. Will be responsible for cultivating relationships with large/complex provider groups to...
JOB SUMMARY This position will be an key position on the Social Determinants of Health (SDOH) team and responsible for supporting the development of SDOH program and initiatives for Highmark Health The role will be respo...
JOB SUMMARY This job serves as the single point of contact for members to coordinate all of the member’s care needs across the various service delivery systems and community supports. This is a full-time community-based...
JOB SUMMARY This job manages a team of Case Managers charged with promoting quality member outcomes to optimize member benefits and to promote effective use of resources for members enrolled in DSHP Plus LTSS. Provides d...
JOB SUMMARY This job, as part of a physician team, ensures that utilization management responsibilities are performed in accordance with the highest and most current clinical standards. The incumbent reviews escalated ca...
JOB SUMMARY This role leads a team responsible for the strategic design, execution, and operational oversight of vendor partnerships within a specific business area. The incumbent will ensure that these strategic partner...
GENERAL OVERVIEW: This job builds and maintains hospital, professional, and ASC contracts in Epic. Identifies underpaid accounts and articulates the source of the processing error to the payor. ESSENTIAL RESPONSIBILITIES...
JOB SUMMARY This job is responsible for managing a book of business and the business relationship as a strategic consultant for existing accounts directly or through intermediaries. The incumbent is responsible for renew...
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