The Director, Provider Information Management, is responsible for provider data management operations across Health Partner Life Cycle (HPLC) and throughout the organization including delegated vendors, solution partners, and client plans. Essential Functions Initiate, develop, implement, optimize, and oversee provider data processes to ensure overall data quality, accura

The Special Investigations Unit (SIU) Investigator Lead is the face of the SIU with external federal and state regulatory agencies and is responsible for regulatory communications to ensure timeliness with these oversight agencies. This role is also responsible for the identification and monitoring of emerging fraud, waste, and abuse (FWA) trends and conducting research a

The OHCW Community Based Care Manager is responsible for working with adult individuals and their care team to develop a person centered care plan to address their home and community based needs, and collaborates with members of an inter disciplinary care team (ICT) to meet the needs of the individual and the population, identifying problems or opportunities that would be

The Health Partner Contracting Specialist II focuses on building and maintaining provider partnerships that optimize network access, availability, and financial outcomes. Essential Functions Identify, evaluate, and onboard healthcare providers to expand the CareSource provider network. Collaborate with providers to negotiate favorable terms and conditions for contracts. E

The OHCW Community Based Care Manager is responsible for working with adult individuals and their care team to develop a person centered care plan to address their home and community based needs, and collaborates with members of an inter disciplinary care team (ICT) to meet the needs of the individual and the population, identifying problems or opportunities that would be

The OHCW Community Based Care Manager is responsible for working with adult individuals and their care team to develop a person centered care plan to address their home and community based needs, and collaborates with members of an inter disciplinary care team (ICT) to meet the needs of the individual and the population, identifying problems or opportunities that would be

The Director, Compliance is responsible for establishing a baseline of compliance risk, identifying areas of potential exposure, developing and aligning compliance risk management strategies with CareSource goals and objectives, and executing the compliance program ensuring effectiveness. Essential Functions Serves as the program compliance officer for an assigned CareSou

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

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 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 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 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

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

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

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