Teams at CareSource

Lead formulary design and strategy across lines of business, manage the Value Assessment Committee, oversee formulary implementation with PBM, monitor drug pipeline, drive cost and outcome-focused KPIs, support rebate negotiations, ensure regulatory compliance, collaborate with clinical programs, analyze data for improvements, and manage, coach, and develop staff.

Lead cross-functional process redesigns and operational readiness for claims lifecycle and systems. Conduct ROI and cost-benefit analyses, manage policy and performance, advise leadership on change management, mentor junior analysts, and ensure regulatory compliance and operational excellence.

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.