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AmeriHealth Caritas

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 impact the lives of millions of people through our national footprint of products, services, and award-winning programs.

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.

Oct 04, 2022
Physician
Medical Director, Utilization Management, REMOTE
AmeriHealth Caritas Remote
This role is eligible for a $10,000 sign-on bonus for external candidates. This role is 100% remote. Qualified candidates, regardless of geographic location, will be considered. The Medical Director provides organizational leadership in the operational areas of care management, utilization review, appeals, quality improvement and related policy and practice initiatives in collaboration with the Corporate Medical Director(s), Utilization Management and the Vice President, Utilization Management Physician. The following responsibilities are in regards to members with medical conditions and their providers: Identifying and implementing evidence-based practice guidelines throughout the provider network. Overseeing the quality of clinical care for network and non-network providers. Engaging the provider network in Continuous Quality Improvement through the diffusion of practice standards, and through an internal quality assurance program that measures network...