Plan Design Specialist works closely with clients to design group health, dental and/or life insurance plans to create an overall benefit package. Works alongside underwriters, but is not an underwriter role. Being a Plan Design Specialist monitors and analyzes cost trends. May handle more complex plan design. Additionally, Plan Design Specialist requires a bachelor's degree or its equivalent. Typically reports to a supervisor or manager. The Plan Design Specialist gains exposure to some of the complex tasks within the job function. Occasionally directed in several aspects of the work. To be a Plan Design Specialist typically requires 2 to 4 years of related experience. (Copyright 2024 Salary.com)
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:
Reporting to the Chief Medical Officer for the Delaware Market, this position is representing UM in state interactions/audits, validation of regulatory reporting/analytics for UM DE, and serves as SME for clinical components DE Medicaid Utilization Management Program. Works in close collaboration with all departments to achieve regulatory standards and optimal departmental outcomes. Develops solutions that may consist of process improvements and/or system development components and are intended to optimize the functionality of the applications and related processes to support the business’ needs. Responsible for being final sign off for regulatory analytics validation. Analyzes the needs of the organization with the commitment to design and implement solutions that best support the needs of the business. This position will solicit ideas for systems improvements, review and present new system enhancements/features, and engage in continuous improvement planning, including testing and roll-out of configuration changes.
Education/Experience:
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.