The IT Business Manager oversees business analysis, reporting solutions, and strategic insights to optimize IT operations and performance.

The Edifecs/EDI Systems Analyst collaborates with stakeholders to gather requirements, develops solutions, and assists with business case documentation and agile user stories. Responsibilities include eliciting software requirements, conducting root cause analysis, and supporting QA activities.

The Provider Engagement Specialist III manages provider contracting, recruitment, and engagement strategies, ensuring regulatory compliance and improved provider relations.

The Systems Analyst II collaborates with stakeholders to define system requirements, translate them into user stories, and ensure documentation throughout the development lifecycle while evaluating solutions for improvement.

The Intelligent Automation Developer III develops intelligent automation solutions using RPA tools like MS Power Automate and UiPath, while focusing on AI/ML integration and process improvement.

The Solution Architect III designs and implements cloud-focused solutions, migrates applications to the cloud, evaluates technologies, leads architectural standards, and collaborates with teams to ensure compliance and optimization in IT systems.

The Manager, Cost Reporting oversees financial data accuracy, prepares cost reports, analyzes trends, ensures compliance, and collaborates across departments to enhance reporting systems.

The Senior Manager, Program Integrity leads initiatives to enhance medical record auditing processes and oversee operations related to coding and reimbursement methodologies.

The MDP Analytical Engineer II designs and optimizes data solutions using Databricks SQL and BI platforms, ensuring data quality and collaboration with stakeholders for actionable insights.

The Analyst executes project plans, analyzes data, ensures regulatory compliance, assists with provider onboarding, and manages communications in the LTSS & HCBS network.

Oversee the Quality Risk Adjustment Medical Record Review program, manage teams, ensure compliance, enhance processes with AI, and improve quality outcomes.

The Manager, Market Quality Improvement oversees quality improvement initiatives, ensures compliance with state and federal regulations, and manages team performance in a healthcare setting.

The AI Engineer II designs and develops generative AI software solutions, oversees architecture, evaluates technologies, and collaborates with teams for project delivery.

The EDI Technical Product Manager leads the strategy and execution of CareSource's EDI platform, ensuring compliance, integration, and high-quality data exchange with stakeholders.

The Clinical Appeals Nurse processes clinical appeals and prepares for state hearings, ensuring compliance with regulatory standards while collaborating with medical staff and communicating with members and providers.

The Actuarial Analyst II conducts analyses and provides recommendations to support corporate initiatives. This involves profitability reporting, evaluating assumptions and government reimbursement, and participating in cross-functional teams.

This role involves designing and implementing information systems and software architectures, providing technical leadership, and managing Facets application solutions with a focus on healthcare payor business outcomes.

The Quality Analyst III analyzes healthcare data, generates reports, collaborates with teams, and provides insights for quality performance improvements.

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

The Internal Auditor II executes internal audits, evaluates organizational risks, develops audit plans, and communicates results to management, enhancing internal controls.