CareSource

Oversee and optimize risk adjustment medical record review programs, leveraging AI technologies, and manage teams and vendors to ensure compliance and quality. | Requires extensive experience in healthcare risk adjustment, medical coding, and AI applications, with leadership skills and relevant certifications. | Job Summary: The Senior Manager, Quality Risk Adjustment is responsible for 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 medical record retrieval and coding. Develop and implement strategic plans to optimize risk adjustment processes and improve overall quality metrics for insourced and outsourced activities MRR. Manage outsourced vendors to execute to operational production plan goals and contractual requirements. Manage vendor administrative expenses including chart copying costs. Work with QRA Compliance Team to establish and maintain MRR quality assurance protocols for medical record retrieval and coding to ensure compliance with all applicable regulations and industry standards. Conduct regular audits and assessments of MRR team’s work for documentation retrieval accuracy, completeness, and efficiencies. Research technological solutions such as the use of artificial intelligence (AI), natural language processing (NLP), work flow management tools, and more to enable more efficient and accurate data collection and reporting of risk adjustment data, ensuring accuracy and timeliness. Collaborate with Data Science, Sourcing, IT, and all necessary stakeholders to deploy AI/NLP solutions. Collaborate with QRA teams, market provider relations teams, providing transparency and timely escalations as needed to ensure operational goals are achieved. Improve insourced retrieval and outsourced vendor work flows and enhance the integration of AI tools in risk adjustment initiatives. Develop and implement training programs for staff on how to most efficiently and effectively retrieve medical records, vendor management principles, and the use of AI tools. Identify opportunities for process improvements and implement initiatives to enhance operational efficiency and quality outcomes. Monitor key performance indicators (KPIs) related to risk adjustment and quality metrics, reporting findings to senior leadership. Perform any other job related duties as requested. Education and Experience: Bachelor's degree in Health Administration, Healthcare Management, or a related field is required Master's degree is preferred Equivalent years of relevant work experience may be accepted in lieu of required education Seven (7) years experience in risk adjustment medical record review program management, medical coding, or quality management in a healthcare setting required Three (3) years of leadership experience required Competencies, Knowledge and Skills: Knowledge of ICD-10 Coding Knowledge of HCC Risk Adjustment models Knowledge of CMS regulatory guidelines Ability to utilize AI Technologies and their applications in healthcare data management and analysis Excellent leadership, communication and interpersonal skills Strong data analytical and problem-solving skills Familiarity with CMS and HHS RADV audits Skilled in vendor management, oversight and performance reporting Licensure and Certification: AAPC CPC (Certified Professional Coder), CRC (Certified Risk Adjustment Coder), AHIMA RHIT, or equivalent preferred Working Conditions: General office environment; may be required to sit or stand for extended periods of time Up to 15% (occasional) travel based on the needs of the department may be required Compensation Range: $113,000.00 - $197,700.00 CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package. Compensation Type (hourly/salary): Salary Organization Level Competencies Fostering a Collaborative Workplace Culture Cultivate Partnerships Develop Self and Others Drive Execution Influence Others Pursue Personal Excellence Understand the Business This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds. #LI-SD1 The CareSource mission is known as our heartbeat. Just as we support our members to be the best version of themselves, our employees are driven by our mission to create a better world for members, stakeholders and providers. We are difference-makers who combine compassionate hearts with our unique business expertise to make every opportunity count. Each claim, each phone call, each consumer-centric decision is a chance to change the world for one member, and our employees look for ways to do that every day. The challenge is, there is no one right way to be the difference and we’re looking for people like you that will rewrite that definition every day. We do what it takes to form creative solutions that make our community and the world just a little better. Discover what it means to be #UniquelyCareSource.

Oversee talent strategy, learning and development, and employee engagement initiatives to align with organizational goals. | Requires 10+ years of executive HR leadership experience, with strong knowledge in talent acquisition, development, and engagement practices. | Job Summary: The Vice President of Talent Strategy will play a critical role in shaping and executing the organization’s talent strategies. This role will oversee learning and development, recruiting, talent management, workplace culture, and employee experience initiatives, ensuring alignment with the company's overall business goals and objectives. Essential Functions: • Design and implement comprehensive learning and development programs that foster employee growth and align with business goals • Evaluate the effectiveness of training initiatives and continuously improve programs based on feedback and performance metrics • Promote a culture of continuous learning and professional development throughout the organization • Develop and oversee talent management strategies, including succession planning, performance management, and employee engagement initiatives • Implement processes to identify high-potential employees and create personalized development plans to prepare them for future leadership roles • Collaborate with senior leadership to ensure alignment of talent management practices with organizational goals • Champion initiatives that enhance the overall employee experience, fostering a positive and inclusive workplace culture • Gather and analyze employee feedback to identify areas for improvement and drive engagement strategies • Work closely with HR teams to address employee concerns and cultivate a supportive work environment • Lead and optimize the recruiting strategy to attract top talent across all levels of the organization • Collaborate with hiring managers to understand workforce needs and develop tailored recruiting plans • Build and maintain relationships with external partners, including recruitment agencies and educational institutions, to enhance talent pipelines • Partner with the CHRO and executive leadership team to align talent strategies with business objectives and drive organizational performance • Provide thought leadership on workforce trends, best practices, and innovative talent solutions • Serve as a mentor and coach to HR and talent management teams, fostering a collaborative and high-performance culture • Perform any other job duties as requested Education and Experience: • Bachelor of Arts/Science degree in Human Resources, Business Administration, or other related field, or equivalent years of relevant work experience is required • Master’s degree is preferred • Ten (10) years of executive leadership experience in human resources, talent management, or a related field is required • Proven track record of developing and implementing successful talent strategies that drive organizational performance required Competencies, Knowledge and Skills: • Strong knowledge of talent acquisition, learning and development, performance management, and employee engagement practices • Excellent communication, interpersonal, and leadership skills • Ability to influence and engage stakeholders at all levels • Demonstrated ability to think strategically while managing operational details • Commitment to the mission and values of the CareSource Family of Companies • Proficient in Microsoft Office Suite (i.e. Microsoft Word, Excel, and PowerPoint) Licensure and Certification: • None Working Conditions: • General office environment; may be required to sit or stand for extended periods of time • Ability to travel as required by the needs of the business Compensation range $150,000-$300,000. CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package. Compensation Type (hourly/salary): Salary Organization Level Competencies • Fostering a Collaborative Workplace Culture • Cultivate Partnerships • Develop Self and Others • Drive Execution • Energize and Inspire the Organization • Influence Others • Pursue Personal Excellence • Understand the Business This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds. #LI-SW2

Oversee and optimize medical record auditing processes, manage a team of auditors, and ensure compliance and quality standards. | Requires 5+ years in medical policy, management experience, health plan experience, and proficiency in Facets and regulatory reporting. | Job Description: • Implement optimization opportunities for prepay and post pay medical record auditing procedures and processes improvement auditing timeliness and quality outcomes • Oversee and ensure that supporting business and regulatory processes and documentation exists and kept current • Track and communicate production issues and escalations to ensure proper follow-up and coordination • Maintain project plans for all projects in which configuration is involved and ensure proper completion of those plans and escalation where timeframes will be changed • Lead new product and new vendor implementations to ensure timeliness and quality of new implementations • Develop and implement ticket controls and ensure that proper communication and approvals are in place prior to system implementation • Oversight and management of team of medical record coding auditors • Analyze and make a determination of appropriate reimbursements and/or modifications of Coding review guidelines in partnership with medical directors and clinical staff. Requirements: • Bachelor’s degree or equivalent years of relevant work experience is required • Minimum of five (5) years of experience in medical policy is required • Minimum of five (5) years of management experience is required • Health plan experience is required • Facets and clinical editing system or equivalent system experience is required • Advanced computer skills and abilities in Facets • Proficient in Microsoft Suite to include, Word, Excel, and Access • Knowledge of regulatory reporting and compliance requirements Benefits: • Bonuses tied to company and individual performance • Substantial and comprehensive total rewards package

Oversee and develop talent strategies, learning and development programs, and employee engagement initiatives to align with organizational goals. | Requires 10+ years of executive HR leadership experience, with proven success in talent strategies and organizational performance. | Job Summary: The Vice President of Talent Strategy will play a critical role in shaping and executing the organization’s talent strategies. This role will oversee learning and development, recruiting, talent management, workplace culture, and employee experience initiatives, ensuring alignment with the company's overall business goals and objectives. Essential Functions: • Design and implement comprehensive learning and development programs that foster employee growth and align with business goals • Evaluate the effectiveness of training initiatives and continuously improve programs based on feedback and performance metrics • Promote a culture of continuous learning and professional development throughout the organization • Develop and oversee talent management strategies, including succession planning, performance management, and employee engagement initiatives • Implement processes to identify high-potential employees and create personalized development plans to prepare them for future leadership roles • Collaborate with senior leadership to ensure alignment of talent management practices with organizational goals • Champion initiatives that enhance the overall employee experience, fostering a positive and inclusive workplace culture • Gather and analyze employee feedback to identify areas for improvement and drive engagement strategies • Work closely with HR teams to address employee concerns and cultivate a supportive work environment • Lead and optimize the recruiting strategy to attract top talent across all levels of the organization • Collaborate with hiring managers to understand workforce needs and develop tailored recruiting plans • Build and maintain relationships with external partners, including recruitment agencies and educational institutions, to enhance talent pipelines • Partner with the CHRO and executive leadership team to align talent strategies with business objectives and drive organizational performance • Provide thought leadership on workforce trends, best practices, and innovative talent solutions • Serve as a mentor and coach to HR and talent management teams, fostering a collaborative and high-performance culture • Perform any other job duties as requested Education and Experience: • Bachelor of Arts/Science degree in Human Resources, Business Administration, or other related field, or equivalent years of relevant work experience is required • Master’s degree is preferred • Ten (10) years of executive leadership experience in human resources, talent management, or a related field is required • Proven track record of developing and implementing successful talent strategies that drive organizational performance required Competencies, Knowledge and Skills: • Strong knowledge of talent acquisition, learning and development, performance management, and employee engagement practices • Excellent communication, interpersonal, and leadership skills • Ability to influence and engage stakeholders at all levels • Demonstrated ability to think strategically while managing operational details • Commitment to the mission and values of the CareSource Family of Companies • Proficient in Microsoft Office Suite (i.e. Microsoft Word, Excel, and PowerPoint) Licensure and Certification: • None Working Conditions: • General office environment; may be required to sit or stand for extended periods of time • Ability to travel as required by the needs of the business Compensation range $150,000-$300,000. CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package. Compensation Type (hourly/salary): Salary Organization Level Competencies • Fostering a Collaborative Workplace Culture • Cultivate Partnerships • Develop Self and Others • Drive Execution • Energize and Inspire the Organization • Influence Others • Pursue Personal Excellence • Understand the Business This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds. #LI-SW2

Manage healthcare quality improvement projects, ensure compliance with regulations, and lead process enhancements in healthcare settings. | Requires healthcare quality management experience, RN licensure (preferred), and management experience, which are not present in your background. | Job Summary: The Manager, Market Quality Improvement manages the day-to-day prioritization of staff activities in collaboration with Director, Quality Improvement. The Manager will be responsible for developing quality documents in compliance with state and federal requirements and work with departments outside of quality to obtain information for reports. Essential Functions: • Responsible for Corporate oversight of the HEDIS Medical Record Review Unit as needed for the assigned market • Responsible for development and oversight of Quality Improvement (QI) Projects and Performance Improvement Projects related to HEDIS and pay for performance (P4P) requirements • Ensures compliance with External Quality Review audits/studies, Performance Improvement Projects, and Quality Improvement Projects required by the state, NCQA, and other accreditation bodies • Responsible for the review of QI issues regarding compliance with Federal, State, and Accreditation requirements • Ensure all policies and procedures are aligned with Federal, State, and Accreditation requirements • Responsible for the annual review, program description, program plan, and update of QI Department policies and procedures • Provide education to internal and external customers on quality improvement functions • Respond to questions that pertain to HEDIS and Quality Improvement from providers and internal staff members • Foster relationships with all internal departments and represents CareSource to community-based and state programs • Collaborate with business owners to establish, implement, and develop best practices for P4P quality directives • Implement opportunities for process improvement that impact quality measurements in assigned market • Monitor industry trends as it relates to healthcare and identify areas of opportunity for improvement • Responsible for ensuring business owners successfully complete all deliverables related to performance improvement plans (PIPs) and quality improvement plans (QIPs) within defined timeframes • Conducts analysis, including root cause analyses with support from identified business units and ensure data is presented and used efficiently to meet the quality goals • Follows enterprise standards and procedures for all quality reporting and documentation and communicate areas of strengths as well as needs to the Quality Improvement Committee • Perform all facets of quality management to include the development of detail work plans, setting deadlines, assigning responsibilities and monitoring/summarizing project progress • Establish, monitor and review mechanisms to assess and document each business units level of compliance with each measure and coordinate corrective actions • Attends and participates in market quality committees • Guide and direct successful completion of daily tasks and projects • Interview, select and train new team members • Conduct performance management activities for direct reports, to include monthly one-on-one meetings, annual performance appraisals, and discipline as appropriate • Perform any other job related instructions, as requested Education and Experience: • Bachelor’s Degree or equivalent years of relevant work experience is required • Completion of an accredited Registered Nursing degree program or Bachelor’s of Science in Nursing (BSN) is preferred • Master’s Degree in Nursing (MSN), Public Health, or healthcare related field is preferred • A minimum of three (3) years of experience in a healthcare or managed care organization is required • Previous management experience is required • Medicaid and/or Medicare experience preferred • Experience in quality metrics preferred Competencies, Knowledge and Skills: • Intermediate proficiency in Microsoft Word, Excel and PowerPoint • Solid leadership skills; able to effectively manage a high performing team, provide coaching and development • Demonstrated ability to adjust and shift priorities, multi-task, work under pressure and meet deadlines • Proven ability to recognize opportunity for improvement and lead change • Data analysis and trending skills • Effective communication skills • Prior supervisory skills • Ability to work independently & in a team environment • Training/teaching skills • Time management skills • Critical listening and thinking skills • Strategic management skills • Decision making/problem solving skills • Customer service oriented Licensure and Certification: • Current, unrestricted Registered Nurse (RN) licensure in the state of practice is preferred • Certified Professional in Healthcare Quality (CPHG) is preferred Working Conditions: • General office environment; may be required to sit/stand for long periods of time • Some in state travel required (approximately 20% of time) Compensation Range: $83,000.00 - $132,800.00 CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package. Compensation Type (hourly/salary): Salary Organization Level Competencies • Fostering a Collaborative Workplace Culture • Cultivate Partnerships • Develop Self and Others • Drive Execution • Influence Others • Pursue Personal Excellence • Understand the Business This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds. #LI-JM1

Manage daily staff activities, oversee contract processing, enforce policies, supervise and train staff, and maintain workflow and reporting. | Requires associate degree or equivalent experience, 2+ years in healthcare/HMO setting, supervisory experience preferred, intermediate MS Office skills, and Facets system knowledge preferred. | Description: • Direct day-to-day staff activities to ensure service and performance objectives are achieved • Manage and maintain workflow/assignments to ensure timely processing of new contracts and maintenance • Document process changes and new procedures to promote consistency in contracts operations • Monitor level of inventory; notify management of levels outside of established thresholds • Create, review, revise and enforce company and department policies and procedures • Responsible for direct supervision of staff including quality review, performance feedback, disciplinary issues and merit/bonus appraisal review • Create and update ongoing staffing plan to address issues that may impact service or provider/internal customer satisfaction • Oversee orientation and training of new Contract Analysts • Analyze staff’s ability to utilize systems and reference materials and make recommendations for improving performance as appropriate • Tracking and reporting of staff production and quality; review in monthly 1:1s • Maintain time sheets for non-exempt employees • Participate in managing external vendor relationships • Perform any other job related instructions, as requested Requirements: • Associates Degree or equivalent years of relevant work experience is required • A minimum of two (2) years of experience in an HMO or health care setting is required • Previous supervisory/leadership experience or completion of the Caresource IC Leadership program is highly preferred • Intermediate level skills in Microsoft Word, Excel and Outlook • Facets system knowledge preferred Benefits: • Health insurance • Retirement plans • Paid time off • Comprehensive total rewards package

Lead complex health strategy and policy team to develop advocacy strategies, monitor regulatory changes, engage stakeholders, and oversee policy integration into business plans. | Bachelor’s degree with 5+ years planning and strategy experience, 3+ years leadership and Medicaid/Medicare policy expertise, strong legislative knowledge, and preferred certifications in Lean/Six Sigma or Project Management. | Job Summary: The Director, Complex Health Strategy and Policy is responsible for leading the complex health strategy and policy team thoroughly analyzing industry trends, best practice, State and Federal policy initiatives to identify actionable business/pilot opportunities for CareSource. Essential Functions: • Oversee and lead key business strategy efforts around complex health and equity including child welfare, disability inclusion, SUD, criminal justice, tribal strategy, social drivers of health, housing etc. • Develop, implement, and lead strategic approaches to advocacy efforts and coordinate, facilitate and advance business and policy priorities across existing state markets and emerging markets • Serve as a liaison between Complex Health Strategy and Policy team and the enterprise. • Act as a key subject matter expert for CareSource on complex populations from a macro perspective • Lead a team to monitor emerging industry policy, regulatory and compliance changes at state or national level for analysis and integration into the corporate business plan • Engage with key stakeholders on a national level to discuss the CareSource value. Examples include national associations, think tanks, advisory groups and trade associations. • Participate in the development of key partnerships with external agencies, associations and consumer advocacy coalitions and other external stakeholders • Develop and implement advocacy strategies in conjunction with the marketing and community services staff, to support and advance corporate strategic goals • Develop white papers, policy briefs and other educational/awareness materials • As applicable, provide strategic oversight of contract lobbyists and perform oversight of administrative functions as necessary • Perform any other job duties as requested Education and Experience: • Bachelor’s degree or other related discipline or equivalent work experience is required • Master’s degree or other related discipline is preferred • Minimum of five (5) years planning and strategy development experience is required • Minimum of three (3) years of experience with Medicaid & Medicare policy/programs and other public health care programs is required • Minimum of three (3) years of leadership experience is required Competencies, Knowledge and Skills: • Thorough understanding of legislative processes at local, state, and federal levels with a primary concentration in policy legislative issues • Strong working knowledge of Medicaid, Medicare and managed care laws, regulations, and financing models • Intermediate proficiency level with Microsoft Office • Broad internet research skills • Technical writing skills • Excellent written and oral communications skills Legislative advocacy skills • Understanding of the public policy process • Strategic thinker with negotiation skills • Strong analytic, research and organizational skills • Knowledge and experience with publicly funded health care programs Licensure and Certification: • Lean or Six Sigma certification is preferred • Project Management Certification is preferred Working Conditions: • General office environment; may be required to sit or stand for extended periods of time • Ability to travel as required by the needs of the business Compensation Range: $132,900.00 - $232,700.00 CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package. Compensation Type (hourly/salary): Salary Organization Level Competencies • Create an Inclusive Environment • Cultivate Partnerships • Develop Self and Others • Drive Execution • Influence Others • Pursue Personal Excellence • Understand the Business This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an inclusive environment that welcomes and supports individuals of all backgrounds. #LI-SW2

Manage readiness preparation and implementation of new health insurance products and markets by collaborating with cross-functional teams and ensuring regulatory and operational compliance. | Bachelor's degree or equivalent, 5 years in healthcare/managed care with experience in health insurance product implementation, knowledge of Medicaid, Medicare, Marketplace products, project management expertise, and strong communication and collaboration skills. | Description: The Market Implementation Manager partners with Business Development, Market and Product leaders, EPMO, IT, vendors, business owners, and other key stakeholders across the company to support the preparation and launch of new lines of business, new markets, market expansions, plan renewals, and mergers and acquisitions.The role focuses on readiness preparation and assessments, implementations, and a smooth transition of new product lines into the business.Influence the development and implementation of overarching plans designed to achieve the business objectives defined by executive leaders for readiness activities and market implementationsCollaborate with EPMO, IT, external vendors, and cross-functional resources to cascade those overarching plans into cohesive sets of actionable and trackable tasksBring a holistic view to implementations and readiness activities including, but not limited to, State/Federal reviews and both pre and post go-live activities, considering the impact on the enterprise and market, and on members, providers, and regulatorsConsider upstream and downstream impacts of decisions and assumptions being made, including financial implicationsWork to enhance communication and visibility with key stakeholders as neededActively participate in preparation sessions, mock audits, and other readiness initiativesCoordinate and facilitate meetings as needed to address roadblocks, make decisions, and gain key stakeholder buy-inStrive for consistency and scalability of solutions across the enterprise when able, with flexibility to tailor tactics to a market or plan’s unique needs, when neededEnsure market requirements will be met as completely, effectively, and efficiently as possible upon go-live, minimizing member, provider, and regulator abrasionIdentify and assist with the rapid resolution or escalation of issues, blockers, and hindrancesDevelop knowledge of plan requirements to review and approve documentation for implementation and readiness submissionsPerform any other job duties as requested Requirements: Bachelor’s degree in business, healthcare, a related field or equivalent years of relevant work experience is requiredFive (5) years of experience in healthcare or managed care industry with experience implementing new health insurance products or markets is requiredBroad working knowledge of government-regulated health insurance products including Medicaid, Medicare, and MarketplaceKnowledge of full range of product requirements from regulatory, operations, clinical, reporting and complianceAble to work independently and in a matrixed team environment, across all levels of the organizationExtensive knowledge of project management processes and terminologyStrong collaboration, relationship building and influencing skillsetProficient with Microsoft Office, including Word, Excel, PowerPoint, and Project, as well as virtual meeting platforms such as Microsoft TeamsCritical listening and systematic thinking skillsStrong oral, written, and interpersonal communication skillsLeadership knowledge and skillsFlexible and responsive to a changing environmentPlanning, problem identification and resolution skillsAbility to maintain confidentiality and act in the company’s best interestConflict resolution skillsAttention to detail as appropriateAbility to identify and communicate opportunities to synthesize and integrate work efforts across teams Benefits: We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package.

Lead and oversee financial data architecture, analytics, governance, and reporting to drive operational efficiency and decision-making. | 10+ years in data solutions architecture with financial data marts experience in healthcare, 5+ years management, advanced Azure and data visualization skills, and strong leadership. | Description: • Set the strategic vision and direction for the organization’s financial data architecture and analytics capabilities • Lead the design, development, and implementation of comprehensive financial data solutions to drive operational efficiency and enhance decision-making across the enterprise • Collaborate with executive leadership and cross-functional teams to ensure financial data initiatives align with organizational goals and regulatory requirements • Build and maintain strong relationships with finance, clinical operations, IT, and market leadership to identify analytical needs and drive successful implementation • Oversee the design and development of advanced financial data models, predictive analytics, and reporting tools to enhance financial performance • Establish and enforce data governance frameworks and policies to ensure data integrity, quality, and compliance • Define and monitor KPIs to evaluate effectiveness and impact of financial data solutions • Prepare and present comprehensive reports to executive leadership and the Board • Advocate for necessary changes in business processes and systems to improve data capture and overall data quality • Identify potential risks related to financial data management and governance and develop mitigation strategies • Perform other job-related duties as requested Requirements: • Bachelor’s degree in Business, Computer Science, Information Management, a related field, or equivalent years of relevant work experience is required • Master’s degree is preferred • Minimum of ten (10) years of experience in data solutions architecture, data governance, or related fields, with specific experience in building financial data marts in a Managed Care Organization (MCO) required • Minimum of five (5) years of management experience is required • Proven experience in healthcare data management, analytics, and financial processes required • Advanced proficiency in Microsoft Azure, Databricks, and data visualization tools such as Power BI or Tableau • In-depth understanding of data warehousing methodologies (e.g., Kimball, Inmon, Data Vault) and best practices in data governance • Exceptional analytical, problem-solving, and critical thinking skills, with the ability to translate business requirements into technical specifications • Outstanding verbal and written communication skills, with the ability to effectively present complex concepts to diverse audiences • Strong leadership and project management skills, with the ability to manage multiple projects simultaneously in a fast-paced environment • Ability to build and maintain effective relationships with stakeholders at all levels of the organization, influencing and driving change effectively • Licensure and Certification: None Benefits: • In addition to base compensation, you may qualify for a bonus tied to company and individual performance. • Substantial and comprehensive total rewards package.

Manage daily operations of customer care team, oversee staffing and scheduling, compile reports, participate in strategic planning, and maintain positive customer relationships. | Bachelor's degree or equivalent experience, minimum 3 years management experience preferred, healthcare or HMO experience preferred, proficiency in Microsoft Office, knowledge of Medicaid, strong leadership and communication skills. | Job Summary: The Manager, Customer Care is responsible to guide Team Leads and staff relative to daily operational issues. Essential Functions: • Ensure quantitative and qualitative objectives are used to meet performance objectives • Manage staffing and scheduling functions • Compile reports and departmental communications • Participate in strategic planning and recommendation of action plans • Interface with team leaders on effective people management strategies such as staffing, coaching and mentoring • Lead/participate in strategic department/company projects • Recommend process improvements • Maintain positive relationship with internal and external customers • Perform any other job duties as requested Education and Experience: • Bachelor Degree in business related field or equivalent years of experience required • Minimum of three (3) years of previous management/leadership experience preferred • Previous experience in an HMO environment or related industry preferred Competencies, Knowledge and Skills: • Proficient in Microsoft Word, Excel, and PowerPoint • Knowledge of Medicaid • Familiarity of healthcare field • Strong management skills • Strong collaboration and conflict resolution skill sets • Proven leadership with the ability to build relationships, collaborate and influence at all levels • Ability to work in a fast-past environment • Attention to detail • Ability to develop, prioritize and accomplish goals/time management • Strong decision making and problem solving skills • Exceptional written and verbal communication skills • Ability to work independently and within a team environment • Effective active listening and critical thinking skills • Display a customer service, member-focused orientation Licensure and Certification: • None Working Conditions: • General office environment; may be required to sit or stand for extended periods of time Compensation Range: $81,400.00 - $130,200.00 CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package. Compensation Type (hourly/salary): Salary Organization Level Competencies • Create an Inclusive Environment • Cultivate Partnerships • Develop Self and Others • Drive Execution • Influence Others • Pursue Personal Excellence • Understand the Business This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an inclusive environment that welcomes and supports individuals of all backgrounds. #LI-KM1