Jobs at CareSource

The Applied AI Scientist III develops and applies advanced analytics using AI to enhance healthcare operations and patient care. This role involves evaluating technologies, leading projects, utilizing NLP and machine learning to extract insights from data, and collaborating with interdisciplinary teams.

The Manager, Clinical Pharmacy Operations oversees Clinical Pharmacy activities, ensuring service consistency, compliance with regulations, and effective utilization of resources, while coaching and developing the team.

The AVP, Finance oversees financial operations, manages budgets and forecasts, leads strategy developments, and ensures compliance with financial reporting standards.

The Business Insights & Planning Analyst III coordinates mergers and acquisition efforts, business planning, and work product development, while managing due diligence and supporting various teams in the business development process.

The Manager leads the Predictive Analytics and Data Science team, develops predictive models, and collaborates with cross-functional teams to drive data-driven solutions in healthcare.

The Payment Cycle Analyst III conducts analyses to identify reimbursement errors, collaborates with teams for testing, and leads special projects to improve claims reimbursement processes.

The Payment Cycle Analyst IV conducts analysis to identify reimbursement errors, collaborates on testing requirements, and leads initiatives on claims payments within healthcare operations.

The Manager of UM Operations Strategy & Implementation oversees compliance, regulatory functions, audits, and process improvements in utilization management, leading a team to ensure alignment with business goals.

The role involves developing and managing complex data sets, creating dashboards, and analyzing data for operational efficiency in healthcare. Collaboration with clinical and IT teams is essential to optimize patient outcomes and processes.

The Program Integrity Clinical Reviewer II evaluates medical records for accuracy, audits claims, provides training, and collaborates across departments to enhance clinical documentation compliance.

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

The Compliance Analyst II supports the Compliance Program through analysis, training, and collaboration, ensuring effective implementation of compliance requirements and managing corrective actions.

The Operations Specialist III provides analytical support for claims projects, leads initiatives, reviews claims, and develops policies for claims processing.

The Operations Specialist II provides analytical support for Claims projects, assists in training staff, resolves provider issues, and analyzes claims data.

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

The Clinical Psychologist provides oversight for Behavioral Health coverage, develops clinical policies, participates in quality improvement, and ensures compliance with regulations while working with providers, members, and state agencies.

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 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.