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: 1 - 10 of 87 |
Triage Nurse - RN - Must be MultiState Licensed - Evening and Every Other Weekend - FT
Job Summary: The Triage Nurse is responsible for using decision support software to perform telephonic clinical triage and health information service for CareSource managed health plans and external clients. Essential Functions: Utilize ass...
9h
| Job Type | Full Time |
Job Summary: The Medical Director is responsible for supporting staff by providing training, clinical consultation, and clinical case review for members. Essential Functions: Provide prior authorization medical reviews, consultation and cli...
9h
| Job Type | Full Time |
Risk Adjustment Coding Auditor II (AAPC or AHIMA coding certification required)
Job Summary: The Risk Adjustment Coding Auditor II is responsible for performing over-reads of vendor ICD-10 coding, reviewing provider documentation supplied to them, and diagnostic codes assigned by vendor. Essential Functions: Meets assi...
9h
| Job Type | Full Time |
Sales Operations Quality Analyst III
Job Summary: Sales Operations Quality Analyst III is responsible for monitoring agent onboarding activities and ensure they align with communicated policies and procedures and comply with federal and state regulations. Essential Functions: ...
9h
| Job Type | Full Time |
PI Medical Coding Reviewer III (CPC, RHIT or RHIA required)
Job Summary: The Program Integrity Medical Coding Reviewer III generates comprehensive and concise in-depth reporting and analysis to track performance related to the Pre-Pay and Post-Paid Processes. Essential Functions: Provide Provider Pr...
15h
| Job Type | Full Time |
PI Medical Coding Reviewer III (CPC, RHIT or RHIA required )
Job Summary: The Program Integrity Medical Coding Reviewer III generates comprehensive and concise in-depth reporting and analysis to track performance related to the Pre-Pay and Post-Paid Processes. Essential Functions: Provide Provider Pr...
15h
| Job Type | Full Time |
Medical Risk Adjustment Vendor Manager
Job Summary: The Medical Risk Adjustment Vendor Manager provides data-driven strategy and risk adjustment subject matter expertise to internal and external stakeholders for Quality Risk Adjustment program execution. Essential Functions: Sup...
15h
| Job Type | Full Time |
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...
21h
| Job Type | Full Time |
Community Based Care Manager - Social Worker in Albany area
Albany, 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...
21h
| 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...
21h
| Job Type | Full Time |