• Job Description

  Req#: 31379

  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 nations 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 hear 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:

  As part of the Community Health Choices Service Coordination Team, the Critical Incident Specialist is responsible for the coordination and ongoing monitoring of Critical Incident reporting program objectives including timely identification, reporting, investigation, review and closure of the critical incident process in the Pennsylvania Enterprise Management System (EIM). Implements and supports the overall Critical Incident process including reporting, metrics, and process improvement. Works collaboratively with Service Coordinators, Quality Management team and leadership.

  Principal Accountabilities:

  • Executes on organizational efforts in ongoing quality improvement processes to ensure compliance with State, Federal, regulatory and accrediting body’s standard requirements.
  • Facilitates and monitors the Critical Incident process in collaboration with Service Coordinators, providers and Quality Management ensuring timely and accurate completing of the CI process with the goal of ensuring Participant health and safety and mitigating future risk.
  • Responsible to participate in reporting needs and process improvement.
  • Identifies resolves and/or escalates problematic QI areas that may place plan at risk of not achieving annual goals.
  • Serves as a resource to other departments in completing Critical Incident requirements and goals.
  • Works professionally and efficiently with all functional areas in meeting organizational and departmental goals.
  • Other duties as assigned.

  Education/ Experience:

  • Associate’s Degree or equivalent work experience required.
  • Bachelor’s Degree preferred.
  • Minimum of 3 years in service quality improvement or service coordination required
  • Minimum of 3 years in human service delivery required.

  Other Skills:

  • Managed Healthcare experience preferred.
  • Excellent organizational, analytical and interpersonal skills.
  • Excellent written and verbal communication skills.
  • Ability to work successfully within all levels of the organization.
  • Proficient PC skills in a windows based environment, including Excel.

  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.

• About the company

  AmeriHealth Caritas is a different kind of health care company. Our goal is to provide responsible managed care solutions, including Medicaid, Medicare, and CHIP — plus pharmacy benefit management, behavioral health, and administrative services.

Notice