Jobs at CareSource

Lead enterprise data platform strategy, architecture, engineering, integration, quality, and operations. Drive cloud modernization, scalable ETL/ELT, data governance, observability, MDM, interoperability, and platform reliability to support analytics, AI, regulatory compliance, and business outcomes. Build and manage senior data engineering and operations teams, vendor relationships, and budgets.

Senior technology leader owning enterprise BI, analytics, data science, and AI strategy. Leads BI, Data Science, and ML Engineering teams; drives model development, MLOps, governance, regulatory compliance (HIPAA/CMS), generative AI adoption, vendor decisions, and executive reporting to improve clinical, financial, and operational outcomes.

Investigate privacy incidents, conduct risk assessments and breach notification, lead HIPAA risk assessments and PIAs, develop privacy policies and training, recommend process improvements, and support organizational privacy program maturity and stakeholder communication.

Perform actuarial analyses and profitability reporting to support management decisions; calculate monthly IBNR reserves; evaluate reimbursement processes; run regular and ad-hoc data studies to improve efficiency, MLR, and operating results; participate in cross-functional initiatives and present findings to stakeholders.

Lead actuarial pricing, forecasting, reserving and modeling efforts. Develop assumptions, maintain actuarial models, evaluate financial experience, support rate filings and IBNR estimates, provide strategic recommendations, manage staff and vendor relationships, and report findings to leadership.

Lead actuarial team activities including pricing, forecasting, reserving, and model development. Produce strategic recommendations, manage actuarial processes and vendor work, support rate filings and regulatory interactions, oversee IBNR reserve estimates, and communicate results to leadership.

Lead enterprise clinical data governance and integration: build/maintain clinical data inventory, standardize acquisition requirements, prioritize ingestion and interoperability (FHIR/HL7), oversee data quality and vendor performance, drive use cases from concept to deployment, partner with IT/Data Engineering, and manage a team of analysts to support governance and analytics roadmaps.

The Configuration Architect oversees the architecture for clinical system configurations, ensures alignment with business needs, evaluates solutions, and leads teams in implementing standards and guidelines while mentoring others in the department.

The Applied AI Scientist III develops advanced analytics solutions utilizing AI technologies, leading projects in predictive analytics and NLP to enhance healthcare operations and patient care.

Senior BI/reporting role focused on LTSS & Dual Eligible programs. Develop ETL pipelines, complex reports, and interactive Power BI/Tableau dashboards; perform advanced data modeling, analysis, and governance to drive operational and clinical improvements.

Lead end-to-end claims automation and AI initiatives: manage intake, prioritize based on ROI, design and implement solutions (RPA/GenAI/LLM), drive testing, adoption, and post-production value tracking across cross-functional teams.

Support operations with regulatory and compliance tasks: analyze claims data, manage audit and regulatory deliverables, draft policies and job aids, train business partners, track corrective actions and regulatory reporting, and collaborate with IT and business owners to resolve data and claims issues.

Design, validate, and operationalize predictive and machine learning models; mine and analyze large datasets; create visualizations and statistical validation; collaborate with teams to integrate solutions and communicate results to stakeholders.