CareSource Management Services Jobs in United States

The Community Based Care Coordinator manages care for dual-eligible beneficiaries. This role focuses on integrating health services and community resources to improve health outcomes.Engage with members in various community-based settings. · Function as a liaison between healthca ...

+The CareSource Intern is responsible for providing support on special projects, · initiatives,and specific activities which will vary by assignment. · +Assisting in facilitation of regulatory audits, · +BenefitsPaid summer internship programJourney-to-the-Job seminars with CareS ...

+The Community Health Worker participates as a member of the inter-disciplinary care team (ICT) to coordinate care for members. · +Engage with the member in a variety of settings to establish an effective, professional relationship · Accompany members to appointments and other so ...

Job Summary:The Grievance & Appeals Specialist II reviews appeals submitted by Medicaid and Medicare providers and all future providers contracted with CareSource. Must live in Indiana. · ...

The IT Business Manager III is responsible for providing business analysis, analytics and strategic insights in order to assist in running the business of IT. · Bachelor's degree in a related field, or equivalent years of relevant work experience required · Minimum of seven (7) y ...

The Community Based Care Coordinator is responsible for managing and coordinating care for dual-eligible beneficiaries. · Engage with the member in a variety of community-based settings to establish an effective care coordination relationship. · Function as a liaison between heal ...

Job Summary: · The Health Partner Incentive Analyst III is responsible for compiling and analyzing financial and clinical data related to health partner incentive programs. · ...

The Transitions Coordinator is responsible for monitoring and managing the functions related to member level of care transitions to and from long-term care, respite nursing facility services, and the enrollment or disenrollment of home and community based (HCBS) waiver services t ...

The Manager, Program Integrity is responsible for managing Program Integrity requirements to include allegation intake, report analysis, triage, investigation, · correction and reporting of fraud. · ...

The Customer Care Specialist I assists members or providers with routine service inquiries. · Must reside within the state of Indiana. · ...

Job Summary: · The Director Provider Contracting executes contracting strategy develops provisions based on cost quality/analysis and monitors key metrics. · ...

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 through culturally competent delivery of care coordinat ...

The Community Based Care Coordinator I – Arkansas with oversight from the care coordination team is the member concierge and is the single point of contact for assessment, person-centered planning, service coordination (funded or unfunded), disease management and transitions betw ...

instED provides patient-centered care in place to adults with complex medical needs. The RN will provide telephonic triage services to ensure referrals are clinically appropriate. · Deliver safe telephonic nurse triage care. · Prioritize referrals based on acuity. · ...

The Medical Director is responsible for participating in the development, implementation and revision of clinical care standards and practice guidelines. · ...

The Vice President Market Operations is responsible for developing the overall market program strategy and business objectives; lead the alignment and collaboration to establish CareSource as the industry leader in member and provider engagement, member and provider experience, · ...

+The Manager, Market Quality Improvement manages the day-to-day prioritization of staff activities in collaboration with Director, Quality Improvement. · +Responsible for Corporate oversight of the HEDIS Medical Record Review Unit as needed for the assigned market · Responsible f ...

The Managing Actuary provides leadership and direction to ensure team goals and strategies are successfully achieved. · Responsible for pricing, forecasting, reserving or other actuarial processes including development of key assumptions · Develop and communicate actionable recom ...

+Job Summary: · Responsible for receiving incoming calls on general 1-800 numbers directs calls as necessary takes detailed messages if unable to complete request of caller. · +Answer handle phone calls warm transfer only as needed. · Assist members finding providers setting up a ...

The Health Partner Engagement Specialist II collaborates with key Health Partners in the development of specific strategies for enhanced engagements.  · Health Partner engagement shall be measured by confidence in CareSource and affiliated Companies' ability to fulfill promises, ...