Company · 397 open roles
Careers at Caresource
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397 positions at Caresource
Rural Health Liaison-(Churchill County Nevada Required)
Caresource·Fallon, NV
Job Summary: The Rural Health Liaison conducts outreach activities and serves as a resource for members, providers, and community-based organizations (CBOs) to address the diverse health needs of rural populations. This role leads outreach initiatives, facilitates education and s…
Manager, Case Management RN- Integrated Care Must Reside in Arkansas
Caresource·Arkansas Mobile
Job Summary: The Manager, Case Management - Integrated Care is responsible for overseeing the Integrated Care Duals Product Teams in coordinating the care, service and health benefits for selected member populations. Essential Functions: • Monitors and promotes safe and effecti…
Hybrid Registered Nurse (RN) Clinical Care Manager - Ipswitch - 5k Sign on Bonus
Caresource·Boston, MA
Job Summary: The Integrated Care Clinical Manager - Massachusetts is a community based registered nurse responsible for providing monitoring, follow-up and clinical care management to dually-eligible enrollees with complex medical, behavioral and social care needs. This position…
Director, Actuarial Science (Medicaid Rate Advocacy, Month End Close, Forecasting)
Caresource·Remote
Job Summary: The Director, Actuarial Science is responsible for guiding the strategic direction, driving innovation and producing key insights for the organization that drive company performance. Essential Functions: • Accountable for Medicaid forecasting, month-end close acti…
Claims Provider Data Oversight Manager
Caresource·Remote
Job Summary: The Claims Provider Data Oversight Manager oversees and manages the enhancement of claim outcomes across existing and emerging lines of business within the Claims organization. Responsibilities include orchestrating collaborative efforts with cross-functional teams t…
Integrated Care Clinical Manager - BH - Quincy, MA
Caresource·Massachusetts Mobile
Job Summary: The Integrated Care Clinical Manager - BH - Massachusetts is a community based BH Clinician responsible for providing monitoring, follow-up and clinical care management to dually eligible enrollees with complex medical, behavioral and social care needs. This positio…
Provider Operations Analyst II (Health Plan/Provider Data Experiencr)
Caresource·Remote
Job Summary: The Provider Operations Analyst II is responsible for assimilating large quantities and/or complicated data into meaningful formats for tracking and status requirements. Essential Functions: • Develop queries to identify and quantify provider data issues within th…
Program Integrity Data Scientist III - Experience supporting fraud detection, program integrity initiatives preferred
Caresource·Remote
Job Summary: The Program Integrity Data Scientist III is responsible for leading the design, development, and deployment of advanced analytical solutions that support payment accuracy, anomaly detection, and Fraud, Waste, and Abuse (FWA) prevention and recovery efforts. This rol…
Compliance Data Analyst II (Health Plan/MCO experience)
Caresource·Remote
Job Summary: The Compliance Data Analyst II is responsible for managing ethics and compliance technology and develop reporting to meet the information needs of the compliance organization. Essential Functions: • Develop, design, and maintain technology solutions and workflows …
SIU Investigator III (Must live in Georgia)
Caresource·Georgia WFH
Job Summary: The Special Investigations Unit (SIU) III is responsible for investigating and resolving high complexity allegations of healthcare fraud, waste and abuse (FWA) by medical professional, facilities, and members. Researches, gathers, and analyzes data to identify trends…
AI Program Manager
Caresource·Remote
Job Summary: The EES Program Manager is responsible for leading and governing enterprise-level programs within Enterprise Engineering Solutions (EES), ensuring alignment to strategic objectives and successful delivery of complex, cross-functional initiatives. This role drives pr…
Integrated Care Clinical Manager - BH - Framingham, MA
Caresource·Massachusetts Mobile
Job Summary: The Integrated Care Clinical Manager - BH - Massachusetts is a community based BH Clinician responsible for providing monitoring, follow-up and clinical care management to dually eligible enrollees with complex medical, behavioral and social care needs. This positio…
Senior Director, Actuarial Science(Preferred Experience In Federal Health Policy Analysis & Advocacy)
Caresource·Remote
Job Summary: The Senior Director, Actuarial Science is responsible for setting the strategic direction, driving innovation and producing key insights for the organization that drive company performance. Essential Functions: • Accountable for pricing, forecasting, month-end clos…
Clinical Nurse Practitioner- Psychiatric (Hybrid) (Greater Boston Area)
Caresource·Boston MA Office (Northampton)
Job Summary: The clinical nurse practioner is a self-directed specialist with advanced knowledge, skills and competence in general medicine and/or specialty in psychiatry. Supervision Exercised: No, this position does not have direct reports. Essential Functions: • Demonstrate…
Hybrid Registered Nurse Clinical Care Manager - Springfield
Caresource·Springfield, MA
Job Summary: The Integrated Care Clinical Manager - Massachusetts at CareSource/Commonwealth Care Alliance is a community based registered nurse responsible for providing monitoring, follow-up and clinical care management to dually-eligible enrollees with complex medical, behavi…
Medical Records Coordinator II (Hybrid/Springfield MA Office)
Caresource·Massachusetts WFH
Job Summary: The Medical Records Coordinator II is responsible for all forms and aspects of retrospective medical record retrieval including, but not limited to, claims data analysis, outreach data research, direct EMR retrieval, Requests of Information (ROI) deployment, pend-re…
RN Clinical Care Manager - Brockton- $5K SIGN ON BONUS
Caresource·Massachusetts Mobile
Job Summary: The Integrated Care Clinical Manager - Massachusetts is a community based registered nurse responsible for providing monitoring, follow-up and clinical care management to dually-eligible enrollees with complex medical, behavioral and social care needs. This position…
Intake Nurse (RN) - Bilingual (Spanish, Russian, or Chinese) (Uniform Assessment System) 10K Sign on Bonus
Caresource·Brooklyn, NY
Job Summary: The Intake Nurse - RN is responsible for assessing potential new members for eligibility for the program and for explaining the program to them and their families. Responsible for knowing required outreach activities within the community and the assessment of eligib…
AI Platform Enablement Engineer III
Caresource·Remote
Job Summary: The AI Platform Enablement Engineer III is responsible for the operational success of enterprise AI platforms by owning the end-to-end enablement, adoption, cost management, and governance execution of AI platforms, including but not limited to Anthropic (Claude), M…
Actuarial Analyst I
Caresource·Remote
Job Summary: The Actuarial Analyst I is responsible for providing timely, accurate, and actionable data and analysis supporting the department, area, and corporate key initiatives. Essential Functions: • Develops actionable recommendations to management relative to all analysi…
Manager, Utilization Management - Must have a MA RN License
Caresource·Massachusetts WFH
Job Summary: The Manager, Utilization Management is responsible for the oversight of all utilization management activities ensuring consistency of services and achievement of utilization targets. Essential Functions: • Assist in coordination and management of the pre-determina…
Pharmacy Technician II Rx Solutions Center
Caresource·Nevada WFH
Job Summary: The Pharmacy Technician II - Rx Solutions Center (RSC) is responsible for handling member, pharmacy, and provider calls related to pharmacy clinical campaigns. This role will require collaboration across different areas within CareSource to ensure best in class serv…
Dir, Finance - Market(Must Live In Georgia)
Caresource·Georgia WFH
Job Summary: Director, Finance – Market provides financial oversight, leadership and support to the market/corporate and ensures the department proactively collaborates with and provides support for analyses being conducted by areas outside the Finance Department. Essential Fun…
Financial Analyst II
Caresource·Ohio WFH
Job Summary: The Financial Analyst II is responsible for preparing analysis for utilization and financial trends, costs, revenues, financial commitments and obligations incurred to predict future revenues and expenses; as well as understand financial impacts of decisions and com…