Associate Director, Compliance(Must Live in Indiana) Hiring Immediately
Job Summary: The Associate Director, Compliance is responsible for establishing a baseline of compliance risk, identifying areas of potential exposure, developing and aligning compliance risk management strategies with CareSource goals and objectives, and executing the compliance program
Director, Customer Care(Must Live In Nevada, Preferred Exper... Hiring Immediately
Job Summary: The Director, Customer Care has overarching responsibility for building a best – in – class service experience for our Members and Providers, across our products and markets. This role serves as a key senior
Director, Customer Care(Must live in Nevada, Preferred Exper... Hiring Immediately
Director, Customer Care(Must live in Nevada, Preferred Experience with Leadership, MCOs and Operations) Director, Customer Care(Must live in Nevada, Preferred Experience with Leadership, MCOs and Operations) The Director, Customer Care has overarching responsibility for building a
Health Partner Network Manager Hiring Immediately
Job Summary: The Health Partner Network Manager executes the Health Partner contracting strategy, develops contract provisions based on cost, quality/analysis and monitors key metrics for the assigned Market. Essential Functions: Create, execute and administer value based
RN - Community Based Care Manager Hiring Immediately
Job Summary: The Community Based Care Manager collaborates with members of an inter-disciplinary care team (ICT), providers, community and faith-based organizations to improve quality and meet the needs of the individual, natural supports and the population
Application Developer III Hiring Immediately
Job Summary: The Application Developer III is responsible for the designing, coding, testing, and analyzing software programs and applications including research, design, documenting and modifying throughout the production lifecycle. Essential Functions: Analyze, Design, code and test
IT Market Director(Must Live In Nevada) Hiring Immediately
The IT Market Director serves as the primary business relationship leader between the IT department and the Market health plan. This role ensures that the market needs are represented across IT for the market’s IT strategies,
Associate Director, Compliance(Preferred Experience in Manag... Hiring Immediately
Associate Director, Compliance(Preferred Experience in Managed Care And Must Live In Indiana) Get AI-powered advice on this job and more exclusive features. Job Summary: The Associate Director, Compliance is responsible for establishing a baseline of compliance
Job Summary: The Customer Care Trainer delivers new hire, upskill and refresher training for Customer Care team members. Essential Functions: Demonstrate SME expertise on business process for Customer Care Member or Provider Services Facilitate courses, leveraging
Job Summary: The Director, Clinical Operations - Care Management directs and oversees the key functions of a team that works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery
Job Summary: The EDI/Edifecs Developer III is responsible for the designing, coding, testing, and analyzing software programs and applications including research, design, documenting and modifying throughout the production lifecycle. Essential Functions: Analyze, Design, code and test
Job Summary: The Team Lead, Claims is responsible for managing and maintaining workflow/assignments to ensure timely processing of claims and research and resolution workload. Essential Functions: Direct day-to-day staff activities to ensure service and performance objectives
Job Summary: The Operations Specialist III provides analytical support and leadership for key Claims-related projects. Essential Functions: Regulatory reporting such as CMS and Medicaid Prompt Pay Serve as high dollar claims reviewer Identify payment integrity issues
Job Summary: The Manager, Customer Care is responsible to guide Team Leads and staff relative to daily operational issues. Essential Functions: Ensure quantitative and qualitative objectives are used to meet performance objectives Manage staffing and scheduling
Job Summary: The Program Integrity Controls Analyst III is responsible for complex Program Integrity requirement for all product lines in all states to ensure delivery on commitments. Essential Functions: Lead SIU implementation of Program Integrity Medicaid/Medicare
Job Summary: The Community Marketing Representative II is responsible to support the enrollment and retention strategy in collaboration with management to ensure all membership goals are successfully achieved. Essential Functions: Utilize an educational approach to community
Job Summary: The Integrations & API Product Manager will be responsible for the end-to-end strategy, development, and execution of Integration and API products and technology platforms across CareSource. This role uses a collaborative approach to create and
Job Summary: Director, Pharmacy – Market is responsible to participate in the Traditional Work Group and lead CareSource market-specific Pharmacy & Therapeutics (P&T) committee. Essential Functions: Act as key pharmacy point of contact for market entities and
Job Summary: The EDI Systems Analyst II or III, depending on experience, is responsible for collaborating with internal and external customers to elicit their business requirements and develop workable solutions. Essential Functions: Leverage appropriate modeling techniques
TrueCare is a Mississippi non-profit, provider-sponsored health plan formed by a coalition of Mississippi hospitals and health systems throughout the state and supported by CareSource’s national leadership in quality and operational excellence. TrueCare offers locally based provider
