Jobs at CareSource

Owns product strategy, vision, operating models, governance, and roadmaps for data migration, integrations, and enterprise transformation initiatives. Translates business and technical objectives into prioritized delivery plans, coordinates cross-functional teams and vendors, oversees readiness, testing, implementation, stabilization, and transition to operations. Manages risks, dependencies, stakeholder expectations, compliance, and executive reporting while guiding product owners and delivery teams.

Oversee cost reporting, financial reconciliations, Medicaid filings, audits, encounter variance analysis, and financial reporting processes. Lead data management, SQL code auditing, and process development in Databricks. Manage staffing, performance, and team development while partnering with finance and encounters teams. Ensure compliance with accounting principles, internal controls, and reporting requirements, and provide financial analysis and leadership support.

Leads enterprise technology programs from planning through delivery, managing scope, schedules, budgets, risks, dependencies, governance, stakeholder alignment, and executive reporting. Partners with leadership to secure resources and prioritization, improves program delivery operations, and uses agentic AI tools to accelerate software development and engineering productivity. Requires experience managing complex, cross-functional IT, data, or engineering programs and familiarity with SDLC methodologies.

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 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.

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.

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.