Company · 251 open roles
Careers at Caresource
Caresource has 251 active roles on ResuMinder right now, with 42% remote-friendly. Score your CV instantly and use the ResuMinder extension to apply in seconds — no manual form-filling.
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251 positions at Caresource
AI Developer (HealthCare Experience)
Caresource·Remote
Job Summary: The AI Developer plays a key role in designing, developing, and deploying intelligent solutions. This role is focused on solving complex business challenges through innovative AI technologies and will collaborate closely with cross-functional teams to ensure timely …
VP, Network Strategy & Contracting(Preferred Managed Care Experience And Must Live In Nevada)
Caresource·Nevada WFH
Job Summary: The VP, Network Strategy & Contracting is responsible for creating and executing the Market Network strategic plan including leading the market with Value Based Purchasing initiatives that differentiate and enable the market to excel, including Pharmacy, Retail and …
Actuarial Analyst I
Caresource·Dayton or United States
Actuarial Analyst I at Caresource. Location: Dayton or United States. Role: analyzing data, preparing reserves, calculating profitability Requirements: Bachelor's in actuarial science/math/economics required; 1 SOA exam passed and active pursuit of ASA; SAS or Microsoft Access pr…
Hybrid Primary Care Triage Registered Nurse (RN) - Massachusetts ONLY
Caresource·Boston or Massachusetts
Hybrid Primary Care Triage Registered Nurse (RN) - Massachusetts ONLY at Caresource. Location: Boston or Massachusetts. Role: performing triage, coordinating care, documenting care Requirements: Perform telephonic clinical triage and care coordination; current MA RN license requi…
Triage Nurse Nights - Compact State Licensed RN
Caresource·Ohio WFH
Job Summary: *Nights - every other weekend, every other holiday* *Shift differential* Essential Functions: • Utilize assessment skills and evidence-based triage guidelines for triage of healthy, as well as acutely or chronically ill or injured members, including pediatric, adul…
Market Quality Improvement Specialist II
Caresource·Nevada WFH
Job Summary: The Market Quality Improvement Specialist II collaborates with department manager and other leadership to evaluate opportunity for HEDIS data and process improvement in new or existing projects with focus on measurable benefits. Essential Functions: • Conducts busi…
Enterprise Medical Director
CareSource·Dayton or United States
Enterprise Medical Director at CareSource. Location: Dayton or United States. Role: developing policies, conducting reviews, supporting staff Requirements: Doctorate in medicine, active unrestricted state medical license, board certification, MCG certification within 6 months, mi…
Provider Improvement Analyst
Caresource·Massachusetts Mobile
Job Summary: The Provider Engagement Specialist - Provider Delegation Performance is responsible for overseeing and improving the performance of delegated partnerships programs and act as the engagement lead for high value, strategic health partners. Essential Functions: • Assu…
Medical Director(Must Have Massachusetts Licensure)
Caresource·Massachusetts WFH
Job Summary: The Medical Director is responsible for supporting staff by providing training, clinical consultation, and clinical case review for members. Essential Functions: • Provide prior authorization medical reviews, consultation and clinical review services • Participate …
Community Based Care Manager
Caresource·Nevada Mobile
Job Summary: 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 co…
Human Resources Business Partner III (New York residency required)
Caresource·Remote
Job Summary: The Human Resources Business Partner III serves as a strategic partner to senior leaders, aligning HR strategies and initiatives with business objectives and organizational culture. Essential Functions: • Serve as a trusted advisor to senior leaders, acting as an i…
Applied AI Scientist III
CareSource·United States
Applied AI Scientist III at CareSource. Location: United States. Role: evaluate technology, lead development, monitor deployment Requirements: Experience in predictive analytics and data science in healthcare; NLP and Generative AI; cloud services; 5 years; advanced degrees prefe…
Medical Director(Must Live In Massachusetts)
Caresource·United States
Medical Director(Must Live In Massachusetts) at Caresource. Location: United States. Role: providing reviews, training staff, conducting reviews Requirements: MD/DO, 5+ years clinical experience, residency completed, managed care medical director experience preferred, advanced de…
BH Provider Engagement Specialist III
Caresource·Boston, MA
Job Summary: The Behavioral Health Provider Engagement Specialist III is responsible for provider contracting services, provider assistance and acts as the engagement lead for high value, strategic BH health partners. Essential Functions: • Execute the quality, engagement, and …
Associate Vice President, Provider Relations(Must Live In Ohio)
Caresource·Dayton WFH
Job Summary: The Associate Vice President, Provider Contracting, Network and Relations informs decision-making around payer and provider best practices related to innovating, supporting and empowering providers in the pursuit of delivering person-centered and high-quality care t…
Hybrid Registered Nurse (RN) Care Manager - Manhattan - MLTC
Caresource·Bronx, NY
Job Summary: The Nurse Care Manager is responsible for providing care coordination including in-home assessment, planning, facilitation, advocacy and authorization of covered plan services to meet the member's health needs while promoting quality cost effective outcomes. Essent…
Revenue Cycle Coordinator III
Caresource·Dayton, OH
Job Summary: The Revenue Cycle Coordinator III is responsible for providing oversight in the research and resolution of member related eligibility and billing complaints from internal customers and governing entities. Essential Functions: • Utilize key accounts receivable and …
Configuration Architect - GuidingCare
Caresource·United States
Configuration Architect - GuidingCare at Caresource. Location: United States. Role: lead architecture, define standards, collaborate stakeholders Requirements: Healthcare domain experience with deep Health Edge/Guiding Care configuration knowledge; 7+ years in advanced clinical s…
Configuration Architect - GuidingCare
Caresource·Remote
Job Summary: The Clinical Systems Configuration Architect is responsible for all architectural disciplines, decision making, drive communication, and collaboration for the enterprise. This role is also responsible for building and maintaining technology strategy for Operationaliz…
Market Chief Medical Director(Must Live In Michigan)
CareSource·United States
Market Chief Medical Director(Must Live In Michigan) at CareSource. Location: United States. Role: lead clinical, develop networks, coordinate education Requirements: MD or DO with residency; 5+ years clinical practice; managed care medical director exp preferred; leadership/busi…
Claims Management Analyst III
CareSource·United States
Claims Management Analyst III at CareSource. Location: United States. Role: Managing EDI, Improving partnerships, Providing SME Requirements: Bachelor’s degree or equivalent; minimum 5 years healthcare operations experience in insurance/managed care; advanced knowledge of healthc…
Hybrid Registered Nurse (RN) Clinical Care Manager - Boston
CareSource·Boston, Massachusetts, United States
Hybrid Registered Nurse (RN) Clinical Care Manager - Boston at CareSource. Location: Boston, Massachusetts, United States. Role: travel visits, coordinate care, advocate patients Requirements: Registered nurse with clinical care management experience; licensed in MA; requires wil…
Hybrid Registered Nurse (RN) Care Manager - MLTC - Brooklyn
Caresource·Brooklyn, New York, United States
Hybrid Registered Nurse (RN) Care Manager - MLTC - Brooklyn at Caresource. Location: Brooklyn, New York, United States. Role: assessing needs, coordinating care, documenting plans Requirements: Registered Nurse with NY licensure, 3+ years experience, geriatrics/long-term care pre…
Hybrid Registered Nurse (RN) Care Manager - MLTC - Brooklyn
Caresource·Brooklyn, NY
Job Summary: The Nurse Care Manager is responsible for providing care coordination including in-home assessment, planning, facilitation, advocacy and authorization of covered plan services to meet the member's health needs while promoting quality cost effective outcomes. Essent…