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Results based on filters ( 307 jobs found )

AI Engineer III – AI Enablement

CareSource
Located in Ohio
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The AI Engineer III – AI Enablement Technical Lead is a senior individual ...
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Summary
About the job:
contributor and the primary hands-on technical leader within AITE. This role is accountable for the technical direction, solution design quality, and implementation integrity of AI-enabled solutions and AITE-owned automation capabilities. Consistent with CareSource’s AI Engineer III career level, this role operates independently on complex, ambiguous problems; sets technical direction within its domain; and leads design and delivery without day-to-day oversight. This role does not own or operate core AI platforms or...
Location:
Located in Ohio
Job Type:
Full-Time
Permanent
Occupation:
Computer Systems Engineers/Architects
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
From:
CareSource
Certifications / Licenses:
Microsoft Certified: Azure Solutions Architect Expert
Microsoft Certified: Azure AI Engineer Associate
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
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Detailed Job Information

Health Partner Engagement Coordinator III-Hybrid

CareSource
Nevada
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Job Summary: The Health Partner Engagement Coordinator III provides ...
Details
Summary
About the job:
high-level administrative support, data management, and operational coordination to the Health Partner Engagement team. Essential Functions: - Maintain accuracy of electronic provider records, profiles, and demographics within databases. - Provide direct support to providers regarding portal navigation and troubleshooting. - Support Health Partner Engagement (HPE) team in the maintenance and development of key relationships. - Manage the HPE mailbox for provider and internal stakeholder inquires and responses. - Submit and...
Location:
Nevada
Job Type:
Full-Time
Permanent
Occupation:
Project Management Specialists
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
From:
CareSource
Certifications / Licenses:
N/A
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
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Detailed Job Information

Clinical Psychologist

CareSource
Located in Ohio
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Job Summary: The Clinical Psychologist provides Behavioral Health coverage ...
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Summary
About the job:
determination for utilization management to ensure members receive appropriate and medically necessary care in the most cost-effective setting. Essential Functions: - Assume responsibility for the overall safety of patients with a BH diagnosis - Serve as the clinical lead in developing and implementing evidenced based clinical policies and practices - Participate in regulatory/accreditation reviews - Assume key role in quality improvement initiatives, case management activities and member safety activities (i.e....
Location:
Located in Ohio
Job Type:
Full-Time
Permanent
Occupation:
Clinical and Counseling Psychologists
Career Level / Education:
Doctoral or professional degree
Salary:
High Income Jobs ($80K-$99K)
From:
CareSource
Certifications / Licenses:
National Committee for Quality Assurance
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Clinical Psychologist

CareSource
Located in Ohio
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Job Summary: The Clinical Psychologist provides Behavioral Health coverage ...
Details
Summary
About the job:
determination for utilization management to ensure members receive appropriate and medically necessary care in the most cost-effective setting. Essential Functions: - Assume responsibility for the overall safety of patients with a BH diagnosis - Serve as the clinical lead in developing and implementing evidenced based clinical policies and practices - Participate in regulatory/accreditation reviews - Assume key role in quality improvement initiatives, case management activities and member safety activities (i.e....
Location:
Located in Ohio
Job Type:
Full-Time
Permanent
Occupation:
Clinical and Counseling Psychologists
Career Level / Education:
Doctoral or professional degree
Salary:
High Income Jobs ($80K-$99K)
From:
CareSource
Certifications / Licenses:
National Committee for Quality Assurance
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Enterprise Medical Director - Behavioral Health

CareSource
Located in Ohio
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Job Summary: Enterprise Medical Director, Behavioral Health is responsible ...
Details
Summary
About the job:
for the overall safety of patients with a BH diagnosis, with a special focus on safe prescribing. Essential Functions: - Support Ohio Behavioral Health Market team program design and development and strengthening community collaboration - Supervise part time Behavioral Health Medical Directors - Serve as the clinical lead in developing and implementing evidenced based clinical policies and practices - Assume key role in quality improvement initiatives, case management activities and member safety activities (i.e....
Location:
Located in Ohio
Job Type:
Part-Time
Full-Time
Permanent
Occupation:
Medical and Health Services Managers
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
From:
CareSource
Certifications / Licenses:
National Committee for Quality Assurance
Board Certified
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Sr Mgr, Quality Risk Adjustment (Health plan/MCO experienced)

CareSource
Located in Ohio
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Job Summary: The Senior Manager, Quality Risk Adjustment is responsible for ...
Details
Summary
About the job:
overseeing the Quality Risk Adjustment (QRA) Medical Record Review (MRR) program which includes chart retrieval and coding while ensuring compliance with regulatory standards and optimizing quality outcomes. This role will also involve leveraging artificial intelligence (AI) technologies to enhance data accuracy, improve efficiency, and overall quality in the chart review program. Essential Functions: - Lead and manage the MRR Team, providing guidance, training, and support to ensure high-quality performance in...
Location:
Located in Ohio
Job Type:
Full-Time
Permanent
Occupation:
Medical Records Specialists
Career Level / Education:
Postsecondary nondegree award
Salary:
High Income Jobs ($80K-$99K)
From:
CareSource
Certifications / Licenses:
Certified Rehabilitation Counselor
ICD-10 / ICD-9
Certified Risk Adjustment Coder
American Health Information Management Association
Certified Radiology Coder
Certified Professional Coder
Registered Health Information Technician
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Behavioral Health Medical Director

CareSource
Located in Ohio
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Job Summary: The Behavioral Health Medical Director is responsible for the ...
Details
Summary
About the job:
overall safety of patients with a BH diagnosis, with a special focus on safe prescribing. Essential Functions: - Assume responsibility for the overall safety of patients with a BH diagnosis, with a special focus on safe prescribing - Serve as the clinical lead in developing and implementing evidenced based clinical policies and practices - Participate in regulatory/accreditation reviews - Assume key role in quality improvement initiatives, case management activities and member safety activities (i.e. incident...
Location:
Located in Ohio
Job Type:
Full-Time
Permanent
Occupation:
Medical and Health Services Managers
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
From:
CareSource
Certifications / Licenses:
Board Certified
National Committee for Quality Assurance
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Care Guide

CareSource
Ohio
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Job Summary: The Care Guides are responsible for participating as a member ...
Details
Summary
About the job:
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 needs are identified. The Care Guide Plus serves as a single point of contact for care coordination when there is a CCE, OhioRISE Plan, and/or CME involvement and short-term care coordination needs are identified....
Location:
Ohio
Job Type:
Full-Time
Permanent
Occupation:
Healthcare Social Workers
Career Level / Education:
Master's degree
Salary:
Upper Middle Income Jobs ($50K-$79K)
From:
CareSource
Certifications / Licenses:
Allied Health Certification
Driver's License
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Health Partner Incentive Manager

CareSource
Located in Ohio
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Job Summary: The Community Health Partner Incentive Manager is responsible ...
Details
Summary
About the job:
for managing value-based reimbursement programs within an assigned market or product. The Health Partner Incentive Manager will manage internal and external stakeholder priorities to ensure customized performance plans address the strategy and goals in a highly matrixed organization which will translate to increased Provider performance and efficiencies. Essential Functions: - Ensure accurate and timely implementation of new Value Based health partner contracts for assigned market - Review Alternative Payment Modelt...
Location:
Located in Ohio
Job Type:
Full-Time
Permanent
Occupation:
Managers, All Other
Career Level / Education:
Bachelor's degree
Salary:
High Income Jobs ($80K-$99K)
From:
CareSource
Certifications / Licenses:
N/A
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Intelligent Automation Developer II - UiPath/Agentic AI

CareSource
Located in Ohio
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Job Summary: The Intelligent Automation Developer II creates and implements ...
Details
Summary
About the job:
Intelligent Process Automation using UiPath and/or Power Automate, Python- AI/ ML solutions based on business requirements and in accordance with standard automation tool design principles and conventions. Essential Functions: - Collaborate with cross-functional teams to identify areas where intelligent/ robotic Process automation and AI/ ML can be applied to streamline processes, reduce manual efforts, and deliver tangible business benefits - Work closely with business stakeholders to gather and define requirements...
Location:
Located in Ohio
Job Type:
Full-Time
Permanent
Occupation:
Software Developers
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
From:
CareSource
Certifications / Licenses:
N/A
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information
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