Jobs at CareSource

The AVP, Network and Contracting oversees provider contracting and network strategy, ensuring compliance and optimizing member access while leading a high-performing team.

Create and manage corporate messaging and content that complies with brand and regulatory standards. Develop external and internal communications assets, coordinate thought leadership and speaking opportunities, support campaigns with internal and external partners, track performance, identify process improvements, and assist on special projects.

Provide timely data, analyses, and recommendations to support departmental and corporate initiatives. Calculate profitability and IBNR reserves, perform regular and ad-hoc analyses to improve efficiency, evaluate assumptions and government reimbursement processes, participate in cross-functional teams, and support initiatives to improve operating results and MLR.

The Claims Management Analyst III leads eBusiness initiatives, manages EDI trading partners, ensures compliance, and analyzes performance for continuous improvement.

The Revenue Cycle Coordinator III ensures timely resolution of member complaints related to eligibility and billing, leads teams, and develops training for compliance with regulatory standards.

The Clinical Psychologist provides behavioral health coverage determination, ensuring appropriate care in a cost-effective setting. Responsibilities include patient safety, developing clinical policies, participating in quality improvement, and serving as a clinical liaison.

The Quality Analyst III analyzes healthcare data, generates reports, collaborates with teams for insights, and ensures quality metrics are effectively communicated.

The Senior Manager leads DSNP bid strategy and execution, ensuring compliant submissions across states, managing risks, and coordinating cross-functional activities related to bid development.

The Senior Manager, DSNP Product Operations leads operational aspects of DSNP products, ensuring compliance, scalability, and efficiency through collaboration and performance oversight.

The Tribal Liaison establishes relationships with tribes and urban Indian health programs, improving health services and collaboration in Nevada's Medicaid service area.

The Configuration Architect oversees the architecture for clinical system configurations, ensures alignment with business needs, evaluates solutions, and leads teams in implementing standards and guidelines while mentoring others in the department.

Design, develop, and deploy AI/ML solutions—especially generative and agentic AI—build LLM and RAG architectures, implement MLOps pipelines, prototype PoCs, and integrate models into production using cloud, containerization, and CI/CD practices while collaborating across teams.

The Provider Engagement Specialist oversees performance of delegated partnerships, manages data reports, collaborates with providers to enhance performance, and ensures regulatory compliance.

The Assistant Clinical Director manages care coordination, ensuring quality service delivery, staff performance, compliance with regulations, and operational oversight of clinical programs.

The DSNP Account Manager acts as a liaison between the organization and DSNP providers, ensuring operational alignment and support for program success through relationship management and education.

The DSNP Account Manager builds relationships with providers, resolves issues, and drives program success while collaborating across teams to improve member and provider experiences.

The Payment Cycle Analyst III conducts analysis to identify reimbursement errors, collaborating with various teams to resolve payment discrepancies and ensure compliance with regulations.

The Applied AI Scientist III develops advanced analytics solutions utilizing AI technologies, leading projects in predictive analytics and NLP to enhance healthcare operations and patient care.

The Clinical Psychologist leads behavioral health coverage determination, ensuring patient safety, developing clinical policies, and guiding quality improvement initiatives in care management.

The Clinical Psychologist ensures correct behavioral health coverage, leads clinical initiatives, participates in quality improvements, and supports regulatory compliance. Responsibilities include training staff, liaising with external partners, and analyzing healthcare data.