Teams at CareSource

Analyze utilization, costs, revenues, and financial trends using claims, eligibility, pharmacy, and clinical data. Produce and validate reports, support forecasting and budgeting, monitor variances, reconcile internal datasets with state records, identify cost-saving initiatives, ensure compliance with regulatory and organizational requirements, and suggest improvements to analysis processes.

Provide behavioral health utilization management, clinical oversight, and quality improvement for members. Develop and implement evidence-based policies, support regulatory/accreditation activities, consult with providers and state agencies, participate in fraud/quality investigations, and provide training and clinical support to staff and markets.

Serve as servant leader and coach for Scrum teams and the organization to adopt Agile/Scrum; facilitate ceremonies, remove impediments, track metrics, support Product Owner, improve processes, and manage stakeholder relationships to deliver projects.