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amerihealthcaritas.phenompeople.com
This fully remote role involves interpreting and applying clinical criteria during the prior authorization review process to approve or direct requests. The position requires utilizing member claims history, making outbound calls for additional information, and submitting authorizations to pharmacy and medical claims processors. The ideal candidate will possess strong knowledge of specialty and non-specialty pharmaceuticals and adhere to corporate policies while maintaining productivity and quality levels.
Headquarters
Philadelphia, Pennsylvania, United States
Company Size
10001+ employees
Founded
1983
AmeriHealth Caritas is a health benefits company that offers Medicaid, Medicare, and Marketplace plans through a broad provider network. The organization concentrates on managed care and care coordination, delivering comprehensive services—from primary and specialty care to behavioral health and social supports—to improve member outcomes. It emphasizes affordable, accessible coverage and value-based care, with programs designed to address social determinants of health and support diverse populations. Operating as part of the AmeriHealth Caritas family of plans, the company focuses on whole-person care across multiple states.
Headquarters
San Francisco, CA
Company Size
201-500 employees
Founded
2018
Industry
Technology
Glassdoor Rating
4.2 / 5
Sarah Johnson
Chief Executive Officer
Michael Chen
Chief Technology Officer
Emily Williams
VP of Engineering
David Rodriguez
VP of Product
Jessica Thompson
Chief Financial Officer
Andrew Park
VP of Sales
View leadership team, funding history,
and employee contacts for amerihealthcaritas.phenompeople.com.
amerihealthcaritas.phenompeople.com didn’t post a salary, so this is our estimate from similar listings.
7% above the average for this role
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