The Customer Care Specialist I assists members or providers with routine service inquiries. Must live in Ohio Training Hours Monday Friday 8a 4 30p EST Post Training Hours Monday Friday 8a 8p EST Part time and Full time positions available Starting pay $18hr Essential Functions Resolve member or provider routine service inquiries; examples include claims processing, membe

The Scrum Product Owner fulfills the role of Scrum Product Owner as defined by the principles of Scrum to maximize the value of the IT product and work of the development team. Essential Functions Develop the strategic vision for an IT product Work closely with the Scrum team to maintain focus on goals, alignment with business needs and urgent matters, and adherence to st

The Enterprise Accreditation Specialist III is responsible for supporting the organization to obtain and maintain appropriate accreditations, distinctions and recognitions through NCQA, URAC or other accrediting bodies. This person will serve as the subject matter expert for various accreditations, including but not limited to NCQA Health Plan Accreditation, LTSS Distinct

The Operations Specialist II provides analytical support and leadership for project impacting Claims and key internal Claims projects. Essential Functions Represent claims on cross functional project work teams Submit, monitor and prioritize IT tickets for the Claims department Review special projects and identify issue trends and potential resolutions Assist with Onbase

The Member Health Assessor engages with the member to establish an effective, professional relationship with primary responsibility to conduct a standardized Health Risk Appraisals (HRA). Essential Functions Verify eligibility, previous enrollment history, demographics and current health status of each member prior to outreach Engage the member to gather information to as

The Compliance Analyst II position is a professional compliance role responsible for supporting the Compliance Program by collaborating and overseeing high risk areas to ensure that the compliance program is effective and efficient in identifying, preventing, detecting, and correcting noncompliance. Essential Functions Provide Compliance Program support with audit and mon

The Sales Coordinator II, in collaboration with team members and leadership, supports the sales strategy and sales enrollment initiatives to ensure annual sales goals are successfully achieved. Essential Functions Work with Leadership to provide support for the internal systems tracking of sales and commissions Manage daily onboarding of agents including validation of com

The Internal Auditor II works in a self directed team environment to execute internal audits as defined by management and the Audit Committee with progressive latitude for team goal setting, initiative and independent judgement on collective work products. The auditor works to identify and evaluate organizational risk, recommends and monitors mitigation action and support

The AVP, Finance is responsible for providing 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 Functions Manages the execution of the annual budget/quarterly forecast including detailed development

Member Engagement Analyst II is responsible for contributing to the overall support of Member Engagement programs by coordinating processes and procedures associated with benefits, retention and member engagement. Essential Functions Support work groups and initiatives for incentive and rewards Supports Consumer Council Meetings (external) Supports the implementation and

The Senior Manager, Technical Claims Adjustments is responsible for providing leadership and direction to employees in the Claim Adjustment department to ensure the goals and standards of the department and CareSource are met. Essential Functions Provide leadership and direction to employees in the Claim Adjustment department to ensure the goals and standards of the depar

CareSource is a healthcare company that's growing rapidly with a lot of exciting things on the horizon. In Florida, ImagineCare was formed by Spark Pediatrics and CareSource to provide differentiating care and service to Florida SMMC Medicaid members and their providers. CareSource is looking for highly skilled professionals to transform the lives of ImagineCare enrollees

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 competent delivery of care and coordination of services and supports. Facilitates communication, coordinates c

Women & Children's Health Coordinator II is responsible to contributes to team coordination and member outcomes. Essential Functions Act as a liaison and advocate of members and providers Enhance member engagement and access to care by assisting member to integrate and optimize CareSource programs Have an understanding of benefits and assist in educating members of benefi

CareSource is a healthcare company that's growing rapidly with a lot of exciting things on the horizon. In Florida, ImagineCare was formed by Spark Pediatrics and CareSource to provide differentiating care and service to Florida SMMC Medicaid members and their providers. CareSource is looking for highly skilled professionals to transform the lives of ImagineCare enrollees