CareSource
CareSource is nationally recognized for leading the industry in providing member-centric health care coverage. The company’s managed care business model was founded in 1989 and today CareSource is one of the nation’s largest Medicaid managed care plans. Headquartered in Dayton, Ohio, the company has built a legacy of providing quality health care coverage for Medicaid consumers. In addition to Medicaid coverage, CareSource has a diverse offering of insurance plans on the Health Insurance Marketplace. The company also offers Medicare Advantage plans that help consumers close the gap of coverage as they age. CareSource serves 2 million members across five states supported by a growing workforce of 4,500.
The CareSource mission of making a lasting difference in members’ lives by improving their health and well-being was the catalyst for developing several programs that target the social determinants of health. The CareSource Life Services® program is designed to enhance the economic outcome of Medicaid members by addressing their unique needs through life coaching, access to resources and job opportunities. Life Services is widely recognized in the managed care industry for partnering with community agencies on behalf of members in order to reduce dependency on governmental services.
In the battle against the opioid epidemic, CareSource has launched a multifaceted approach to decrease opioids and increase access to treatment. This effort includes an award-winning prescriber outreach program in addition to pharmacy edits and pharmacy lock-in which have resulted in a significant reduction in opioid prescriptions. CareSource supports members seeking treatment with an integrated Medication Assisted Treatment (MAT) program that is grounded in a strong and expanding provider network and committed to providing access to quality care.
CareSource’s holistic model of care called Care4U® breaks down the hurdles of clinical treatment and social qualities that can lead to reduced health outcomes. Our members are more than a name on computer screen or a number in a statistic. Our regional, community-based multi-disciplinary care management teams comb through the data and social aspects that could affect physical, mental, and psychosocial health and integrates insights into how to improve the health and overall well-being of our members and the populations we serve.
At CareSource, our mission is one we take to heart. In fact, we call our mission our “heartbeat.” It is the essence of our company, and our unwavering dedication to it is a hallmark of our success.
Search among CareSource jobs
| Jobs: 11 - 20 of 110 |
Physical Health RN Clinical Care Reviewer II
Las Vegas, Nevada
Job Summary: Clinical Care Reviewer II is responsible for processing medical necessity reviews for appropriateness of authorization for health care services, assisting with discharge planning activities (i.e. DME, home health services) and ...
1d
| Job Type | Full Time |
Physical Health RN Clinical Care Reviewer II
Winnemucca, Nevada
Job Summary: Clinical Care Reviewer II is responsible for processing medical necessity reviews for appropriateness of authorization for health care services, assisting with discharge planning activities (i.e. DME, home health services) and ...
1d
| Job Type | Full Time |
Las Vegas, Nevada
Job Summary: The Manager, Member Services serves as the primary point person ensuring that business operations - including Enrollment, Call Center, Grievance and Appeals, and others, are working effectively to provide a high quality custome...
1d
| Job Type | Full Time |
Job Summary: The Actuarial Analyst II is responsible for providing timely, accurate, and actionable data, analysis and recommendations supporting the department, area, and corporate key initiatives. Essential Functions: Develops actionable ...
2d
| Job Type | Full Time |
Utilization Management Market Operations Manager
Las Vegas, Nevada
Job Summary: The Utilization Management (UM) Market Operations Manager is responsible for the operational activities of UM and Appeals for a specified line(s) of business managing the development of policies and procedures, review of team m...
2d
| Job Type | Full Time |
Ridgeland, Mississippi
Job Summary: The Grievance & Appeals Specialist II reviews appeals submitted by Medicaid and Medicare providers and all future providers contracted with CareSource. . Essential Functions: Prepare the appeals for clinical review and be respo...
2d
| Job Type | Full Time |
Team Lead, Configuration Testing - Facets/Benefits Configuration Testing is a must
Job Summary: The Team Lead, Configuration Testing is responsible for day-to-day activities surrounding the knowledge and insight around testing of medical benefits, provider reimbursement, letters, claims workflow and clinical editing. Esse...
3d
| Job Type | Full Time |
Operations Software Quality Analyst II - Facets/Benefits Configuration Testing is a must have
Job Summary We are seeking a highly skilled Operations Software Quality Analyst II to join our team, specializing in Facets Benefits Configuration testing. In this role, you will collaborate with developers, QA team members, and managers to...
3d
| Job Type | Full Time |
RN Community Based Care Manager
Atlanta, Georgia
Job Summary: 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 a...
5d
| Job Type | Full Time |
RN Community Based Care Manager
Macon, Georgia
Job Summary: 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 a...
5d
| Job Type | Full Time |