AmeriHealth Caritas · 1 day ago
Program Integrity Recovery Analyst
Newtown Square, PA
Full-time
Onsite
Entry, Mid Level
3+ years expAmeriHealth Caritas is a mission-driven organization focused on delivering comprehensive health care solutions. The Program Integrity Recovery Analyst is responsible for managing overpayment recovery projects and ensuring that recovery opportunities result in realized recoveries, working closely with internal and external stakeholders.
Health CareInformation Technology
Responsibilities
Manage overpayment recovery Project files from various submitters and multiple lines of business
Ensure adherence to established Program Integrity (PI) Project file management processes, including overall quality control through the recovery Project’s lifecycle
Provide regular Project-related feedback to PI Management and submitters through delivery of written status updates as well as during scheduled and/or ad-hoc meetings
Utilize strong functional expertise in multiple business areas – including Program Integrity, Claims, and Health Plan Operations – to effectively analyze Project-related data and identify overpayment trends
Make recommendations for process improvements that can eliminate or diminish repeated overpayment issues
Produce and distribute accurate and timely recovery Project-related reports
Work independently as well as with Peers, Manager, and Associates at all levels involving problems/issues that could have a significant financial or organizational impact
Qualification
Required
Minimum of 1 year's experience in a managed care environment with specific experience in medical claims terminology, claims payment, recovery, and/or claims data research and analysis
Minimum of 3 years of analytical experience, preferably with Medical Claims data
Bachelor's Degree or equivalent Medicaid and/or AmeriHealth Caritas experience
Health Care experience required; Medicaid and Medicare experience preferred
Successful experience working in a team setting, as well as on large and small project teams required
Proficiency with MS Access and/or experience importing data into databases, creating queries and reports required
Working knowledge of Microsoft Office applications to include Excel, Access, Word, and PowerPoint
Preferred
Health Care experience required; Medicaid and Medicare experience preferred
Business Intelligence tools and SQL experience are a plus
SharePoint experience is a plus
Benefits
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
Company
AmeriHealth Caritas
AmeriHealth Caritas is the health care solutions provider for those in most need and the chronically ill.
10001+ employees
H1B Sponsorship
AmeriHealth Caritas has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (18)
2024 (17)
2023 (12)
2022 (14)
2021 (4)
2020 (11)
Funding
Current Stage
Late StageLeadership Team
Kathleen Giblin
SVP Clinical Operations
Ash Hanson
Executive Vice President & Chief Human Resources Officer
Recent News
2025-11-06
The Philadelphia Inquirer
2025-10-02
2025-10-01
Company data provided by crunchbase