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amerihealthcaritas.phenompeople.com
This role involves interpreting clinical criteria and utilizing member claims history to review and approve prior authorization requests for pharmaceutical services. The specialist handles inbound and outbound communications, processes appeals, and collaborates with pharmacists and providers to ensure optimal medication therapy and favorable costs. The position requires strong knowledge of specialty and non-specialty pharmaceuticals, adherence to federal and state regulations, and the ability to multitask in a fast-paced environment.
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.
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