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Manager, Provider Credentialing Operations Implementation

CareSource Management Services LLC
Dayton, OH
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83085205 286920036 Job Summary: The Manager, Provider Credentialing ...
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Operations Implementation is responsible for managing provider credentialing processes for new market implementations within a managed care organization. This position will ensure that all providers meet necessary standards, comply with regulatory requirements, and are efficiently onboarded and maintained within the system. Essential Functions: Manage and lead a team of credentialing specialists to ensure the timely and accurate credentialing of healthcare providers Design and implement credentialing policies, workflows, and...
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FP&A Program Manager IV

CareSource Management Services LLC
Dayton, OH
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83073396 286904437 Job Summary: The first 12 months in this role will be ...
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managing an administrative cost reduction program which will include tracking of savings initiatives, meeting with leaders to discuss savings opportunities, preparation of presentations and presentations to leaders, validation of savings achieved. Once project is complete will transfer to more traditional FP&A role which will include working with leaders are budget-to-actuals, forecast/budget preparation, etc. The Financial Analyst IV is responsible for leading and analyzing utilization and financial trends, costs,...
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Healthcare Quality Business Development Specialist

CareSource Management Services LLC
Dayton, OH
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82722199_1 286899252 Job Summary: The Healthcare Quality Business ...
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Development Specialist supports the Quality function of new business implementations through reviewing and understanding current and prospective contracts and informing content for proposals, including identifying, collecting and managing documentation required for responses to Requests for Proposals (RFPs) and other business-related proposals. This role will serve as a Quality liaison between Enterprise Implementation Organization, Enterprise Project Management Organization and the Quality & Performance Organization. Essential...
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Intelligent Automation Developer III

CareSource Management Services LLC
Dayton, OH
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491419 286898198 Collaborate with cross-functional teams to identify areas ...
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where AI/ML and intelligent automation can be applied to streamline processes, reduce manual efforts, and deliver tangible business benefits. Work closely with business stakeholders to gather and define requirements for AI/ML and intelligent automation projects. Translate business needs into technical specifications. Analyze and preprocess data to ensure quality, relevance, and suitability for AI/ML model development and collaborate with data engineers to establish data pipelines and data governance. Design, develop,...
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Application Developer III

CareSource Management Services LLC
Dayton, OH
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487389 286898127 Analyze, design, code and test software through the ...
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production lifecycle according to functional/technical specifications that meet business requirements. Run and monitor software performance tests on new and existing software for the purposes of correcting errors, isolate areas for improvement, and general debugging. Administer critical analysis of test results and deliver solutions to problem areas. Assist in software deployment as required based on build specifications. Liaise with network administrators, systems analysts, and software engineers to assist in resolving...
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LTSS Provider Network Operations Analyst II

CareSource Management Services LLC
Dayton, OH
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83069146 286894264 Job Summary: The Provider Network Operations Analyst II ...
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executes small to medium scale project plans, business and data analysis, and provides specialized support of the LTSS & HCBS provider network and EVV compliance initiatives. Essential Functions: Analyze data, workloads, and processes to enhance operations efficiencies in support of LTSS & HCBS providers. Identify trends and solutions to operational support and ensure provider adherence to regulatory and contractual requirements. Perform quality assurance reviews to ensure that provider information is loaded correctly,...
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5
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Architect II - Digital Solutions

CareSource Management Services LLC
Dayton, OH
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83064807 286893964 Job Summary: The Application Architect II - Digital ...
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Solutions is responsible for the system design and development of critical frontend platform elements that will support our Digital systems. Additionally, expected to play a key role in defining and delivering strategies to help our Digital platform scale at a national level. Essential Functions: Partnerships Driving strong partnerships with our internal Cloud, DevOps, Security, Site Reliability Engineering, and Solution Architecture teams aimed at enabling the Digital Solutions delivery teams. Demonstrate strong...
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6
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5
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LTSS Provider Relations Account Manager

CareSource Management Services LLC
Dayton, OH
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83069143 286894050 Job Summary: The LTSS Provider Relations Account Manager ...
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is responsible for working in a highly matrixed organization and influencing internal stakeholder relationships. This role will engage with LTSS and HCBS providers to build, manage and maintain relationships, with a strong focus on operational efficiencies, proactive engagement, and reduced burden which all leads to retention of provider relationships and improving member access to care. Essential Functions: Own the relationship with LTSS and HCBS providers with a proactive focus on overall provider satisfaction and...
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From:
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Workkeys
Applied Math
4
Graphic Literacy
5
Workplace Documents
4
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Manager, LTSS Provider Relations

CareSource Management Services LLC
Dayton, OH
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83069144 286894172 Job Summary: The Manager, Provider Relations-LTSS is ...
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responsible for overseeing and encouraging the collaboration with LTSS/HCBS providers and key stakeholders in the implementation of specific strategies for enhanced operational engagement, overall provider satisfaction, operational performance and compliance of the LTSS and HCBS provider network. Essential Functions: Oversee the ownership of provider relationships through providing proactive, high-level account development and support to drive the overall satisfaction, engagement and retention of LTSS & HCBS provider...
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From:
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Certifications / Licenses:
Workkeys
Applied Math
5
Graphic Literacy
5
Workplace Documents
5
apply
Detailed Job Information

Market Clinical Quality Specialist II

CareSource Management Services LLC
Dayton, OH
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83064803 286891401 Job Summary: The Market Clinical Quality Specialist II ...
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completes assigned case/file reviews to ensure adherence to regulatory requirements and identified Standard Operations Procedures (SOPs).. Essential Functions: Ensure compliance with adherence to regulatory requirements and identified Standard Operating Procedures (SOPs) through monthly inter-rater reliability monitoring of case reviews Identify departmental training and development opportunities and work collaboratively with peers and Care Management to develop the needed education and/or training Assist Management...
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From:
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Certifications / Licenses:
Workkeys
Applied Math
4
Graphic Literacy
5
Workplace Documents
5
apply
Detailed Job Information
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