Jobs at CareSource

Manages daily accounting and reporting operations, including financial statement preparation, regulatory reporting, audits, internal controls, payments, accounting standards compliance, and system implementations. Analyzes financial trends and obligations, supports new programs, oversees timely filings, handles ad hoc analysis, and manages departmental staff. Requires accounting expertise in GAAP and/or statutory accounting, strong analytical and leadership skills, and preferably CPA certification and healthcare experience.

Lead cloud, DevOps, and SRE architecture efforts to scale CareSource's digital platform. Partner with Cloud, DevOps, Security, and SRE teams to design infrastructure, build Terraform templates, enhance CI/CD pipelines, implement monitoring/alerting, and improve reliability, scalability, and incident response for enterprise-scale digital products.

Designs, validates, and operationalizes predictive, machine learning, and AI models using large structured and unstructured datasets. Performs statistical analysis, develops visualizations and dashboards, presents findings to stakeholders, and integrates solutions across teams. Provides clinical-program analytics, evaluates data science tools, mentors junior scientists, leads concurrent projects, and prepares end-to-end model pipelines for business use.

Designs, validates, and operationalizes predictive, machine learning, and artificial intelligence models using large structured and unstructured datasets. Performs statistical analysis, feature engineering, exploratory analysis, visualization, and clinical program outcome validation. Collaborates cross-functionally to integrate solutions, prepares end-to-end model pipelines, and communicates analytical findings to stakeholders to improve business processes.

Leads provider network operations, value-based contracting, risk adjustment, quality improvement, financial planning, and strategic initiatives. Oversees provider relationships, network access, regulatory compliance, performance measurement, contract-management systems, vendor selection, and operational redesign. Develops market plans, represents the organization externally, presents recommendations to executives, and manages support teams, including hiring and development. Requires healthcare network management and leadership experience, with managed care experience preferred.

Provides administrative support to the Market President and office, including preparing presentations, correspondence, reports, calendars, meetings, travel arrangements, expense reports, and meeting minutes. Serves as an office gatekeeper and coordinates facilities, shipping, equipment, visitor badges, and market events. Requires discretion, confidentiality, strong communication, organization, problem-solving, and Microsoft Office proficiency.

Owns CareSource’s EDI platform vision, roadmap, backlog, and delivery. Translates healthcare, regulatory, and integration requirements into technical specifications; partners with engineering, architecture, QA, DevOps, trading partners, and business teams; coordinates releases and Agile delivery; monitors transaction performance, defects, SLAs, and platform telemetry; drives data quality, observability, automation, compliance, documentation, and continuous improvement across EDI capabilities.

Leads quality and population health analytics using advanced statistics, epidemiological study design, predictive modeling, and quality improvement methodologies. Collects and analyzes healthcare data, predicts HEDIS and STAR ratings, evaluates interventions, supports compliance reporting, and communicates findings to business and administrative leaders. The role requires collaboration with quality leaders and market owners to improve health outcomes and inform strategic decisions.

Manages information security risks, vendor and third-party risk reviews, mitigation plans, policy exceptions, and compliance reporting. Partners with stakeholders and Enterprise Risk Management to maintain risk policies within tolerance. Serves as a technical expert, supports risk awareness and accountability, monitors security controls, and contributes to operational goals. The role requires expertise in IT audit, security monitoring, access management, encryption, networking, incident response, SOX compliance, and project management.

Lead a small actuarial team responsible for pricing, forecasting, reserving, and actuarial modeling for supplemental benefits. Develop assumptions, evaluate experience and trends, support rate filings and IBNR reserve estimates, provide strategic recommendations, and ensure compliance with actuarial standards.

Manage day-to-day operations for national provider network programs: create integrated workplans, run program cadence, track milestones, manage risks/issues, synthesize executive reports, coordinate cross-functional teams, promote AI-enabled tools, and support leadership presentations to ensure timely delivery and alignment.

Lead enterprise adoption and toolchain integration for business analysis across federated teams. Design enablement curriculum, integrate standards and AI-enabled tooling (Azure DevOps, ServiceNow, Nexus, Power BI), build decision-oriented dashboards and leading indicators, drive adoption and governance, surface portfolio trends, and partner with stakeholders to improve delivery predictability and compliance.

Lead the actuarial function to drive pricing, forecasting, rate filings, and financial analysis. Develop statistical models, ensure regulatory compliance, mentor staff, support senior management and business development, and implement AI-enabled solutions to improve efficiency and insights.

Lead actuarial pricing, forecasting, reserving and modeling efforts. Develop assumptions, maintain actuarial models, evaluate financial experience, support rate filings and IBNR estimates, provide strategic recommendations, manage staff and vendor relationships, and report findings to leadership.