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Individual & Group Coverage: (800) 400-PCHP
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Careers

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Welcome to Piedmont Community Health Plan's jobs page.  As Central Virginia's very own managed healthcare organization, we're dedicated to providing our members with access to medical care that represents the highest standards for quality and efficiency.

To view and or apply for any of the following positions, click CENTRA HEALTH CAREERS and follow the prompts:

  1. Scroll to the bottom and select  "Piedmont Community Health Plan" from the "Select a Facility" box.
  2. You may further your search by selecting a job category or job status.
  3. Click on "Search."

Current Job Openings

Analyst Operations

The operations analyst is a key member of the operations team supporting general operations, data management, customer service, data analysis, issue identification and resolution, and other related duties as assigned by department leadership. The person will be responsible for assisting the Operations Department at the direction of department leadership with the day to day operations of all lines of business within PCHP to include, but not limited to, Commercial, Medicare Advantage and the Exchange.

Product Coordinator

This individual assists the Product Manager of Government Programs – Exchange/Affordable Care Act(ACA) with government healthcare plan daily operation functions. These duties include, but are not limited to: investigating and resolving Health Insurance Casework System(HICS) cases, supporting enrollment discrepancy resolutions, track and chart product metrics, assisting the claims/enrollment Third-Party Administrator (TPA) with reconciliation of Centers for Medicare & Medicaid Services (CMS)/Piedmont records, addressing complex inquiries/issues internally and externally, performing member outreach, process returned mail, and support process improvement initiatives.

Rep Sales Government Insurance Product

This position will conduct direct sales of government based products for eligible groups and individuals. In addition, position will assist potential customers, navigators, and brokers in understanding products offered in Virginia Bureau of Insurance and CMS approved service areas.

RN Case Manager

Responsible for the day to day implementation of the case management programs. Assure effective interface and cooperation with other departments in order to implement effective patient care and achieve medical management goals.

Specialist Compliance

The Compliance Specialist contributes to the development, implementation, and maintenance of the compliance program, policies, and procedures. Coordinates the internal audit programs. Promotes an awareness and understanding of positive ethical and moral principles consistent with Piedmont's Code of Conduct and core values, and those required by federal and state law.

Technical Writer

The Technical Writer PCHP position is responsible for documents and other required materials associated with Piedmont Community Health Plan's regulated product lines of business, to include but not limited to, commercial, Medicare Advantage, and Exchange. Functions include research, writing, proper approvals and print preparation.

Utilization Review Clerk

The Utilization Review Clerk provides support services for office processes including utilization review and basic systems administration for the Medical Management department. This position also provides phone based customer service to both members and providers. The Utilization Review Clerk is also delegated the responsibility of approving specific benefit authorizations and works under the supervision of an appropriately licensed health professional.

Utilization Review Nurse

Piedmont Community Health Plan's medical management department is searching for a full time Registered Nurse to join our team.

This role performs utilization review services for a variety of services, including both inpatient and outpatient services, within the established criteria and regulatory timeframes.  The nurse will promote effective utilization and monitoring of health services.  The nurse will communication and collaborate with providers and members to manage coverage of services.  The nurse will refer members to case management as appropriate.

 

 

As a local employer of choice, Piedmont is committed to diversity.  As such, we are an Equal Employment Opportunity and Affirmative Action Employer.  Please see below for current job openings.  Thank you for your interest in Piedmont Community Health Plan.