The Application Developer II 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 software through the production lifecycle according to functional/technical specifications that meet bu

Clinical Care Reviewer II NICU is responsible for processing medical necessity reviews for appropriateness of authorization for health care services, assisting with discharge planning activities (i.e. DME, home health services) and care coordination for members enrolled with a CareSource Management Group line of business, as well as monitoring the delivery of healthcare s

The Quality Analyst III is responsible for analyzing and interpreting complex healthcare data. This role will collaborate with cross functional teams, providing analytical insight to inform strategy and interventions to drive improved quality performance Essential Functions Generate comprehensive reports, graphics and dashboards that effectively summarize and display data

The Triage Nurse is responsible for using decision support software to perform telephonic clinical triage and health information service for CareSource managed health plans and external clients. Essential Functions Utilize assessment skills and the nursing process for care of healthy, as well as acutely or chronically ill or injured clients, including pediatric, adult, ma

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 through culturally competent delivery of care and coordination of services and supports. Facilitates communication, coordinates c

The Data Scientist III is responsible for designing and validating predictive models, machine learning models, and artificial intelligence that inform and improve business processes across the organization (operational, clinical, financial, marketing, etc.). Essential Functions Create, maintain, and communicate analytical plan for each project Balance progress in multiple

The Enterprise Data Architect is responsible for designing, creating, and managing CareSource's enterprise wide data architecture. This role is critical in establishing a solid foundation for data management and data processing flow throughout the CareSource ecosystem, ensuring that data is organized, accessible, secure, and aligned with business objectives. The Enterpris

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 through culturally competent delivery of care and coordination of services and supports. Facilitates communication, coordinates c

The Manager, Dynamics Application Development is responsible for setting the vision and direction for SharePoint and the D365 Customer Relationship Management platform with best practices and understanding of the vision at CareSource IT. The role will have oversight over D365 and power platform development, system integrations, web services, API and data integration devel

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 through culturally competent delivery of care and coordination of services and supports. Facilitates communication, coordinates c

The Quality Analyst IV is responsible for developing, implementing, modeling, and leveraging high volume and highly complex healthcare data to transform into advanced analyses or visual analytic solutions. This role will collaborate with cross functional teams, providing analytical insight to inform strategy and interventions to drive improved quality performance. Essenti

The Risk Adjustment Analyst III is responsible for compiling and analyzing member information to ensure the Risk Adjustment Factor accurately reflects the member health profile, financial and clinical information. Essential Functions Compile and analyze member information to ensure the Risk Adjustment Factor accurately reflects the member health profile, financial and cli

The Manager, Medical Risk Adjustment Programs & Operations is responsible for managing performance, activities and SLAs of outside vendors who are partnered with for risk adjustment interventions. This position is full time, remote. Essential Functions Operates in a matrix environment influencing and managing collaborative risk adjustment initiatives with other internal f

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 through culturally competent delivery of care and coordination of services and supports. Facilitates communication, coordinates c

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 through culturally competent delivery of care and coordination of services and supports. Facilitates communication, coordinates c