Jobs at CareSource

Provides financial leadership for a market or region through reporting, budgeting, forecasting, business reviews, reimbursement and pricing analysis, regulatory filings, audits, risk assessment, internal controls, and quality improvement initiatives. Partners with executives, regulators, actuaries, providers, and market leaders while managing finance staff and supporting growth, revenue maximization, and strategic decision-making.

Leads ElderServe Health’s legal, compliance, regulatory, governance, and risk functions. Advises executive leadership, oversees legal and regulatory strategy, ensures compliance with healthcare laws and government program requirements, manages significant transactions and partnerships, represents the organization with regulators and stakeholders, and develops departmental capabilities, budgets, talent, and performance measures.

Provide financial leadership and oversight for a region/market: reporting, budgeting, forecasting, regulatory filings, rate advocacy, risk and IBNR analysis, audit coordination, staff management, and strategic support to market and corporate leaders to meet targets.

Leads actuarial strategy, pricing, forecasting, financial analysis, statistical modeling, rate filings, regulatory engagement, and performance monitoring. Manages actuaries, develops staff, ensures actuarial standards compliance, supports business development and policy matters, and provides insights on financial drivers, trends, assumptions, and healthcare market performance.

Performs actuarial analysis supporting business and corporate initiatives, including profitability reporting, assumption studies, efficiency analysis, IBNR reserve calculations, reimbursement risk evaluation, and medical loss ratio improvement. Develops recommendations for management, analyzes financial and operational data, and collaborates on cross-functional initiatives. Requires a relevant bachelor’s degree, at least one Society of Actuaries exam, and active pursuit of an ASA designation.

Own enterprise AI platform enablement, adoption, cost optimization, configuration, rollout, and usage governance. Manage access models, guardrails, adoption metrics, consumption trends, and compliance controls across platforms such as Claude, Microsoft Copilot Studio, and Microsoft 365 Copilot. Partner with engineering, finance, security, legal, architecture, and vendors to drive measurable value, maintain operational playbooks, and align platform usage with enterprise standards. Requires Azure AI, Kubernetes/AKS, and CI/CD experience.

Leads digital strategy, transformation, and roadmap development across member and provider experiences. Directs personalized engagement programs, omni-channel adoption, performance measurement, vendor partnerships, budgets, and digital teams. Aligns technology with business needs, defines customer journeys, promotes user-centered design, and drives organizational change. The role also hires and develops talent, presents digital vision to executives, and manages large initiatives under tight timelines.

Leads systems research and business analysis to identify impacted systems, interfaces, dependencies, and affected business areas. Elicits and documents requirements, creates Agile features and stories, facilitates stakeholder workshops, performs root cause analysis, supports QA testing, and develops training and documentation. Serves as a liaison between technical teams and business users while analyzing complex processes and enterprise systems in a healthcare environment.

Manages digital products from planning through delivery, optimization, communication, and performance tracking. Owns product roadmaps, backlogs, budgets, customer experience, digital strategy, Agile prioritization, stakeholder alignment, agency and IT partner coordination, compliance, and analytics. Leads digital innovation projects, translates business requirements into technical and user experience solutions, and guides teams using Lean Management and Design Thinking principles.

Leads digital products from planning through delivery, execution, communication, and results tracking. Responsibilities include product roadmap and backlog management, customer journey mapping, stakeholder alignment, market and competitive analysis, Agile ceremony facilitation, prioritization of digital initiatives, vendor coordination, and product optimization. The role applies Lean Management and Design Thinking, validates business propositions, supports self-service experiences, and ensures regulatory compliance. It requires five years of digital project experience and strong product, project management, UX, and analytics knowledge.

Manages information security risks, vendor and third-party risk reviews, mitigation plans, policy exceptions, and compliance reporting. Partners with stakeholders and Enterprise Risk Management to maintain risk policies within tolerance. Serves as a technical expert, supports risk awareness and accountability, monitors security controls, and contributes to operational goals. The role requires expertise in IT audit, security monitoring, access management, encryption, networking, incident response, SOX compliance, and project management.

Leads enterprise technology architecture, governance, design validation, roadmaps, lifecycle management, vendor assessments, and IT due diligence. Partners across technology teams to establish architecture strategy and standards while improving cost, availability, security, client experience, and flexibility. Requires substantial IT experience, architecture or technical leadership background, AI security expertise, full-stack development experience, and fluency in Python and server-side JavaScript or TypeScript.

Develop and deploy AI-enabled applications, web interfaces, and workflow integrations using low-code platforms and modern programming frameworks. Build Python and SQL automation, integrate generative AI and NLP capabilities, collaborate with data and business teams, and support testing, troubleshooting, Agile delivery, deployment, and incident management. Ensure solutions meet usability, accessibility, compliance, and performance standards.

Leads advanced data science and machine learning initiatives for healthcare payment integrity, including fraud, waste, and abuse detection, anomaly identification, predictive modeling, statistical analysis, dashboards, and recovery investigations. Provides technical leadership, mentors analysts, integrates production analytical solutions, collaborates with legal and business stakeholders, and presents findings to leadership. Requires healthcare expertise, advanced SQL and programming skills, and knowledge of claims, billing, reimbursement, and program integrity.

Lead a small actuarial team responsible for pricing, forecasting, reserving, and actuarial modeling for supplemental benefits. Develop assumptions, evaluate experience and trends, support rate filings and IBNR reserve estimates, provide strategic recommendations, and ensure compliance with actuarial standards.

Lead the actuarial function to drive pricing, forecasting, rate filings, and financial analysis. Develop statistical models, ensure regulatory compliance, mentor staff, support senior management and business development, and implement AI-enabled solutions to improve efficiency and insights.