Teams at CareSource

Lead SIU investigator responsible for identifying and mitigating Medicaid/Medicare fraud, liaising with state and federal regulators, using data analytics to detect FWA, mentoring investigators, managing complex investigations, ensuring regulatory reporting accuracy, and coordinating corrective actions and legal processes.

Lead provider contracting, recruitment, and engagement for an assigned market. Negotiate and manage hospital, physician, ancillary, and behavioral health contracts; analyze financial and performance data; support value-based reimbursement and population health initiatives; coordinate credentialing/loading; mentor staff; ensure regulatory compliance and participate in joint operating committees to drive provider performance and satisfaction.

Lead provider contracting, recruitment, engagement, and performance initiatives for an assigned market. Negotiate contracts, analyze financial and quality data, support value-based reimbursement and practice transformation, coordinate with analytics and population health, mentor new hires, and ensure regulatory and accreditation compliance while managing heavy territory travel.