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The Community Based Care Coordinator I BH/SUD is the member concierge and is the single point of contact for assessment, person centered planning, service coordination (funded or unfunded), disease management, utilization management and transitions between all levels of care. Essential Functions Understand and implement Person Centered Thinking Facilitate the Person Cente
Posted 2 days ago
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
Posted 2 days ago
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
Posted 2 days ago
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
Posted 2 days ago
The Vice President, Market Chief Medical Officer has accountability for ensuring that local health plan, CareSource initiatives focusing on clinical excellence, quality improvement, appropriate inpatient and outpatient utilization, affordability, health system transformation including provider network, compliance with regulatory mandates, growth and other focused improvem
Posted 2 days ago
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
Posted 2 days ago
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
Posted 2 days ago
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
Posted 2 days ago
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
Posted 2 days ago
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
Posted 2 days ago
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
Posted 2 days ago
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
Posted 2 days ago
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
Posted 2 days ago
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
Posted 2 days ago
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
Posted 2 days ago
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