Jobs in the United States

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Added just now
Assistant Manager I
Family Dollar
Chireno, TX
We’re seeking an Assistant Store Manager to join our team to help with store operations, customer service and team development. Duties include, but are not limited to, the following:
Added just now
Assistant Manager I
Family Dollar
Las Vegas, NM
We’re seeking an Assistant Store Manager to join our team to help with store operations, customer service and team development. Duties include, but are not limited to, the following:
Added just now
Assistant Manager II
Family Dollar
Kersey, CO
We’re seeking an Assistant Store Manager to join our team to help with store operations, customer service and team development. Duties include, but are not limited to, the following:
Added just now
Assistant Manager II
Family Dollar
Stephenville, TX
We’re seeking an Assistant Store Manager to join our team to help with store operations, customer service and team development. Duties include, but are not limited to, the following:
Added just now
Assistant Manager II
Family Dollar
Lubbock, TX
We’re seeking an Assistant Store Manager to join our team to help with store operations, customer service and team development. Duties include, but are not limited to, the following:
Added just now
Assistant Manager I
Family Dollar
Whitesboro, TX
We’re seeking an Assistant Store Manager to join our team to help with store operations, customer service and team development. Duties include, but are not limited to, the following:
Added 1 min ago
Account Executive Italy
Fortive
Remote, United States
…through to negotiation and contract signature, and act as account manager for our existing Italian customers, owning renewals, upsell and expansion in the country. You will engage senior…
Added 1 min ago
T
Construction Project Manager IV
TEKsystems
Trenton, SC
- $80 to $105 USD / hour
…customers. Our expertise in strategy, design, execution and operations unlocks business value through a range of solutions. Were a team of 80,000 strong, working with over 6,000 customers,…
Added 1 min ago
T
Senior Contracts Manager
TEKsystems
Midlothian, TX
- $29.68 to $48.4 USD / hour
…customers. Our expertise in strategy, design, execution and operations unlocks business value through a range of solutions. Were a team of 80,000 strong, working with over 6,000 customers,…
Added 2 mins ago
Engineering Manager (Weekend)
Ralliant
Hollister, CA · Hollister
The Engineering Manager (Weekend) position is a key technical leadership role within PacSci EMC. The Engineering Manager provides leadership to and participates on a team of engineering…
Added 3 mins ago
Senior Institutional Success Architect
Juniper Square
Remote, United States
…Juniper Square is to unlock their full potential. We’re the Operations Partner trusted by 2,300+ GPs, unifying technology, data, and fund administration services into a single platform that…
Added 3 mins ago
Category Specialist (Mandarin)
Chewy, Inc.
Plantation, FL
Set up and implement promotions as per category manager direction
Added 3 mins ago
RU
Manufacturing Technician II, DAP (Nights)
Resilience US, LLC
West Chester, OH
- $21.5 to $32 USD / hour
This position operates on a 2-2-3 Schedule, 12 hour shifts - 6pm-6:30am
Added 3 mins ago
Manager Performance and Insights
Jackson National Life Insurance
Lansing, MI
The Manager, Performance and Insights leads the development, analysis, and reporting of operational metrics that support Facilities, Corporate Real Estate, and planning functions. This role…
Added 3 mins ago
SC
Senior Budget Management Consultant (Manager IV)
Stanislaus County
Modesto, CA
- $51.22 to $76.84 USD / hour
The ideal Senior Budget Management Consultant (Manager IV) is a proactive, organized professional who thrives in a fast-paced environment and supports executive leadership in driving…
Added 4 mins ago
CH
Senior Construction Manager
CPS HR Consulting (Client Recruitments)
Greenwood Village, CO
- $135,000 to $155,000 USD / year
…northwest Douglas County. Reporting to the Capital Programs Manager, the Senior Construction Manager will support planning and preconstruction and help lead projects through construction,…
Added 4 mins ago
Service Delivery Manager - Business Platforms (Global)
Torrance, CA
We are seeking an experienced Service Delivery Manager – Business Platforms (AMER) to join our Technology Services team.
Added 5 mins ago
Area Manager
Chewy
Ocala, FL
Chewy is hiring an Area Manager for our Ocala, FL. Fulfillment Center! This individual will lead all aspects of the direction of hourly associates in the accurate receiving, and storage…
Added 5 mins ago
TR
Director of Food & Beverage
Terranea Resorts
Rancho Palos Verdes, CA
- $165,000 to $185,000 USD / year
Must have proven track record building sales, via promotional activities, up-selling techniques and sound marketing · Must have knowledge of health department rules and regulations, liquor laws and regulations
Added 6 mins ago
Supervisor, Field Sales (Starlink) - OR
SpaceX_Global
Remote, United States
Reporting to the National Sales Manager, you will turn the sales approach and messaging aligned with Starlink/SpaceX leadership into effective execution at the doorstep. Your team will sell…
Added 6 mins ago
Supervisor, Field Sales (Starlink) - MO
SpaceX_Global
Remote, United States
Reporting to the National Sales Manager, you will turn the sales approach and messaging aligned with Starlink/SpaceX leadership into effective execution at the doorstep. Your team will sell…
Added 6 mins ago
Supervisor, Field Sales (Starlink) - IL
SpaceX_Global
Remote, United States
Reporting to the National Sales Manager, you will turn the sales approach and messaging aligned with Starlink/SpaceX leadership into effective execution at the doorstep. Your team will sell…
Added 6 mins ago
Supervisor, Field Sales (Starlink) - IL
SpaceX_Global
Remote, United States
Reporting to the National Sales Manager, you will turn the sales approach and messaging aligned with Starlink/SpaceX leadership into effective execution at the doorstep. Your team will sell…
Added 6 mins ago
Supervisor, Field Sales (Starlink) - IA
SpaceX_Global
Remote, United States
Reporting to the National Sales Manager, you will turn the sales approach and messaging aligned with Starlink/SpaceX leadership into effective execution at the doorstep. Your team will sell…
Added 6 mins ago
Supervisor, Field Sales (Starlink) - IA
SpaceX_Global
Remote, United States
Reporting to the National Sales Manager, you will turn the sales approach and messaging aligned with Starlink/SpaceX leadership into effective execution at the doorstep. Your team will sell…

Amerihealth Caritas

Per Diem Medical Director Utilization Management

United States

Apply on careers.amerihealthcaritas.com About employer

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Job details

Posting language: English
Posted: Nov 10, 2026

Original job description

For roles that are 100% remote or hybrid, you must have access to a reliable high-speed internet connection to support daily job responsibilities. A minimum bandwidth of 50 Mbps download and 5 Mbps upload is required. Those fully remote associates residing in states where service is required by contract, law, or regulation will be allowed to submit for reimbursement. Your career starts now. We’re looking for the next generation of health care leaders. 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. 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. Job Summary Reporting to the Senior Medical Director of UM, the Per Diem UM Medical Director will be responsible for:

Performing daily medical reviews, appeals, participating in appeal panel as appropriate, correspondence regarding review determinations and physician peer review activities.
Identifying and implementing evidence-based practice guidelines throughout the provider network. · overseeing the quality of clinical care for network and non-network providers.
Utilizing evidence-based standards in making coverage determinations.
Management policies; meeting health plan inter-rater reliability guidelines.

Work Arrangement: Fully Remote Hours: Minimum of 10 hours a week and not to exceed 20 hours a week. Evening, weekend and holiday coverage required

Accountabilities:

Ensures the provision of quality and clinically sound services to all Enrollees by associates and Providers.
Serves as medical advisor and manager for all clinically related activities.
Assures that organization medical policies and procedures adhere to contractual obligations.
Performs clinical case reviews in conjunction with Medical Excellence Department.
Demonstrates knowledge of prescribed and established medical procedures and practices.
Maintains familiarity with federal, state and local regulations that may pertain to the medical and clinical operations.
Maintains compliance with applicable regulatory guidelines, AmeriHealth Caritas clinical policies and procedures, and contractual obligations.
Manages day-to-day operations and monitors the integration and processing of members to optimize appropriate use of behavioral and physical health services.
Participates with Quality Improvement and Medical Excellence in the identification and analysis of medical and behavioral health information to develop interventions to improve clinical effectiveness of medical management strategies.
Works closely with a multidisciplinary team to ensure behavioral health management and quality management programs are meeting contractual obligations.
Works with the leadership of the Quality Improvement and Medical Excellence departments to develop competent clinical staff.
Attends case management meetings and monthly rounds as scheduled.
Collaborates with the integrated case management team, during scheduled meetings and informally as needed.
Thoroughly documents all care coordination activity in the member medical record in the electronic case management documentation system.
Adheres to AmeriHealth Family of Companies (ACFC) policies and procedures and supports and carries out the ACFC mission and values.

Education/Experience:

Doctor of Medicine (MD) or Doctor of Osteopathic Medicine licensed to practice as a medical director; additional state licensure required in all states where ACFC has a line of business, and that application is expected within 120 days of hire.
Must be Board Certified in a specialty with a current and unrestricted license.
Must be clear of any sanctions by the applicable state or Office of the Inspector General.
Must not be prohibited from participating in any Federally or State funded healthcare programs.
Minimum of 1 year of Health Plan experience.

Other Skills:

Strong written and oral communication skills-required.
Demonstrated competency in use of healthcare data.
Demonstrated excellent interpersonal communication skills and presentation skills.
Experienced in conflict resolution and negotiation.
Understanding of and expertise in quality improvement and medical economics.
Strong leadership skills.
Excellent analytical and problem-solving skills.
Demonstrated ability to access department’s work quality and develop / implement process improvements to achieve regulatory and oversight compliance.
Maintain current knowledge of and applies all applicable licensing, regulatory and industry standards.

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.

Apply on careers.amerihealthcaritas.com About employer

More about this job

Skills

Regulatory compliance
Quality assurance procedures
Case management
Documentation
Communication skills
Presentation skills
Conflict resolution
Negotiation
Leadership
Problem solving

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Work requirements

Jobs in the United States