Medical Management Initiative Specialist

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:

The Medical Management Initiative Specialist will provide consultation, technical assistance, and program management support in the areas of health promotion/pay for performance or contract mandated quality or health promotion programs. The incumbent will lead programmatic development, implementation, optimization, analysis, and documentation of programmatic results.

• Manages and coordinates programs and activities associated with the department’s quality or health promotion goals
• Manages projects geared toward program development, initiation, maintenance, and analysis helping to guide and enable operations based on strategy and goals determined for the programs.
• Create program status reports, drafting work plans and timelines and coordinating other project management functions.  
• Works in consultation with appropriate market, product, and enterprise leadership in strategic direction and planning of program initiatives.  
• Facilitates programs through workplan development and identification and communication with internal and external stakeholders.  
• Collaborates with internal and external stakeholders, managing all levels of relationships
• Maintains and analyzes program data for trends and accuracy and fosters further strategic and/or operational improvements
• Will design and develop innovative programs to support quality and health promotions goals in collaboration with clinical, quality, and business leadership at the local market and enterprise population health organizations.
• Works in alignment with the overall business goals and objectives; including HEDIS, NCQA, and specific product/market goals. 
• Manages all phases of project management for quality or health promotion initiatives to ensure timely completion of all projects, including technology components

Education/Experience:  

• Bachelor’s Degree.
• Quality Improvement or project management experience (certification preferred) 
• Performance improvement training (LEAN, Six Sigma, IHI etc.)
• Minimum of 3 years of experience in similar function or related field with level of accountability commensurate with responsibilities described.  Proven skills in analyzing reported data to collect relevant statistics.  Depending on functional area, experience includes:
  • Experience in quality or health promotion initiative development and monitoring.
  • Strong collaboration and communication skills including leading cross-disciplinary teams.
  • Data & analysis skills.
• Proficiency with productivity tools to include Microsoft Word, PowerPoint, Excel, Teams, and Visio.
• Medicaid managed care experience preferred.

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.