<p>Your career starts now. We're looking for the next generation of health care leaders.</p> <p>At AmeriHealth Caritas, we're 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'd like to hear from you.</p> <p>Headquartered in Newtown Square, PA, 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.</p> <p>Discover more about us at www.amerihealthcaritas.com.</p> <p>Responsibilities:</p> <p>Program Coordinator has primary responsibility for the administration of several efforts supporting the Keystone Health Plan East Children's' Health Insurance Program (CHIP) contract with the Pennsylvania Department of Human Services (PA DHS).</p> <ul> <li>Works cross-departmentally, and with PA DHS and Office of Income Maintenance (OIM) to ensure all details of the mandated PH-95 Waiver Program process are handled according to compliance requirements on a timely and efficient basis. </li><li>Completes PH95 process for referrals to Medical Assistance and serves as primary liaison with internal and external entities. </li><li>Sets up PH95 referred cases, ensures outbound member calls are made by applicable area, tracks and documents all activity in repository and in CAPS State system. </li><li>Executes mailing of bi-annual Federally Qualified Health Center (FQHC) provider prescription claims reconciliation letters </li><li>Creates marketing initiatives relating to print and web efforts, orders promotional supplies, tracks status of efforts </li><li>Works in internal, HMHS and state systems to accomplish tasks. Analyzes cost center spend and coordinates details to complete and submit quarterly reports to PA DHS. </li><li>Monitors INSINQ daily. Troubleshoots, investigates, solves and/or routes all issues, such as legislative, outreach and PH95, to appropriate person or team. </li><li>Stays knowledgeable about, and submits and tracks information through, various software systems to meet CHIP teams goals, including state proprietary Docushare system to submit and track Programmatic Creates and submits change Form requests for approval by PA DHS; Health Solutions My EHS Portal to access INSYNC; Catalyst for invoice submissions, coding and research. Maintains logs of all submissions, as applicable, including submission and approval dates, informs team of statuses. </li><li>Responsible for newsletter issue planning, development, and distribution. Coordinates with internal departments and vendors, as needed. Applies edits, obtains, and provides distribution list to vendor, ensures supply of newsletters is available for team's distribution. Submits requests to load latest newsletter on our CHIP website. Catalogs past newsletters and articles. </li><li>Responsible for FQHC Provider Drug Claim Reconciliation mailing twice per year. Works with Provider Reimbursement, Provider Communications, and Disbursement and Accounting Reconciliation areas to obtain provider claims and address data, and ensure letters and supporting documentation are produced, error-free and mailed timely. </li><li>Completes Quarterly Marketing Post Report and Quarterly Marketing Intended Report through coordination with Outreach team, Financial Planning and Analysis, Accounts Payable departments, Marketing and other areas, as needed. Analyzes, researches, and organizes all cost center expenses for accurate inclusion in report; rectifies errors with applicable departments. Submits accurate reports to PA DHS on schedule. </li><li>Communicates directly with PA DHS and OIM about potential referrals of CHIP members to Medical Assistance. </li></ul> <p>Education/Experience:</p> <ul> <li>Bachelor's Degree: Business, Health Care Administration or related field preferred. </li><li>3-5 year preferred experience in CHIP, Medicaid, and/or Medicare program/account management preferably within a health or managed care organization. </li></ul> <p>Diversity, Equity, and Inclusion</p> <p>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.</p> <p>We keep our associates happy so they can focus on keeping our members healthy.</p> <p>Our Comprehensive Benefits Package</p> <p>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.</p>