The Care Guides are responsible for participating as a member of the inter disciplinary Care Coordination Team to coordinate care for members, meeting their individual needs and the needs of the population. The Care Guide serves as a single point of contact for care coordination when there is no CCE or OhioRISE Plan and/or CME involvement & short term care coordination ne

The Care Guides are responsible for participating as a member of the inter disciplinary Care Coordination Team to coordinate care for members, meeting their individual needs and the needs of the population. The Care Guide serves as a single point of contact for care coordination when there is no CCE or OhioRISE Plan and/or CME involvement & short term care coordination ne

The Manager, Provider Network Performance provides leadership and direction to staff to ensure the goals of the department are successfully achieved. Essential Functions Ensure accurate and timely implementation of new Value Based Reimbursement (VBR) initiatives Lead value based reimbursement team projects focused on the continued development and automation of VBR program

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 Director, Risk & Insurance has overall responsibility for the organization's insurance and reinsurance programs. Essential Functions Lead the organization's captive reinsurance companies and look for ways to leverage captive structure Maintain relationships with brokers, carriers, and third party vendors Oversee the purchase of all insurance and reinsurance coverage f

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

The Community Health Worker participates as a member of the inter disciplinary care team (ICT) to coordinate care for members. Essential Functions Engage with the member in a variety of settings to establish an effective, professional relationship. Settings for engagement include but are not limited to; hospital, provider office, community agency, member's home, telephoni

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

The Investment Accountant III is responsible for performing the day to day accounting functions related to investment portfolios, with a focus on ensuring accurate and timely reporting of the investing activity in compliance with Generally Accepted Accounting Principles (GAAP), Statutory Accounting Principles (STAT) or other basis as deemed applicable. Essential Functions

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 Claims Lifecycle Process Manager is responsible for leading and managing the efforts to improve the claim outcomes for existing and new lines of business within the Claims organization. This will involve working closely with cross functional teams to develop and execute project plans, manage risks, track progress, lead process improvement initiatives, and drive change

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