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Sr. Enterprise Clinical Quality Specialist

CareSource - Dayton, OH

Role and Responsibility: Complete assigned case/file reviews to ensure adherence to National Committee for Quality Assurance (NCQA), State requirements, and Federal requirements Execute compliance with adherence to applicable regulatory requirements, accreditation ..

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Call Center Customer Care Advocate

CareSource - Dayton, OH

Role and Responsibility: Assist members with routine service inquires including but not limited to; selecting a primary care physician, member benefit education, member identification cards, transportation arrangements, issues with provider accessibility, ..

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Quality Improvement Specialist - Ohio Market

CareSource - Dayton, OH

Role and Responsibility: Collaborates with department manager and other leadership to evaluate opportunities for HEDIS data and process improvement in new or existing projects with focus on measureable benefits Conducts business ..

Enrollment Specialist

CareSource - Dayton, OH

Role and Responsibility: Process work items according to appropriate regulatory guidelines Review files and interpret the data to enter members into eligibility systems Completion of daily change file ...

Health Partner Manager

CareSource - Youngstown, OH

... creating awareness around targeted communities within CareSource. Develop and provide proactive, high- ... support and enhance relationship to key CareSource health partner(s) within assigned community ...

RN Care Manager

CareSource - Cleveland, OH

... according to standards of practice and CareSource policies regarding professional documentationStarts each intervention ... is required for this role. CareSource will provide the Influenza vaccination ...

Care Manager - Marketplace

CareSource - Dayton, OH

Role and Responsibility: Develop and implement care plan, defining specific issues, goals and interventions as agreed to by all parties Monitor and evaluate care plan on an ongoing basis through ...

RN Care Manager

CareSource - Dayton, OH

... according to standards of practice and CareSource policies regarding professional documentation Starts each ... to make the members experience with CareSource easier and shares with leadership to make ...

Enterprise Clinical Quality Specialist

CareSource - Dayton, OH

... monitoring activities via Clinical Care Advance, OnBase, Streamline, Facets, and CareSource policy and procedures Assist in identifying and evaluating the organizations ...

Encounters Data Submission Analyst

CareSource - Dayton, OH

... that is either rejected by the agencies or delayed by CareSource prior to submission Work with Finance and various operational business ...

Team Lead, Customer Care Issue Resolution Team

CareSource - Dayton, OH

... overall second level support to frontline Customer Care specialists across CareSource sites ensuring efficient handling of all inquiries in an accurate ...

Behavorial Health Regional Coordinator

CareSource - Indianapolis, IN

... assigned Region to ensure achievement of CareSource’s strategic and business plans. Additionally ... Provide Support and oversight to the CareSource Behavioral Health Partners Program Responsible for ...

Vendor Oversight Manager

CareSource - Dayton, OH

... Develop delegation oversight document evidence and pre-delegation tools for CareSource compliance, state, Federal and Quality audits/ accreditation initiatives Conduct pre ...

Supplemental Benefits Specialist

CareSource - Dayton, OH

... to improve member experience and CareSource competitiveness Assist with the implementation of ... communicate variances in compliance. Facilitate vendor/CareSource operational and strategic meetings, as ...

Employer Relations Specialist

CareSource - Cleveland, OH

... Services Program Educate employers on CareSource and Life Services Policies and ... Title: Employer Relations Specialist Company Name: CareSource Industry: Healthcare / Health Services Job Function ...

Strategic Sourcing Manager

CareSource - Dayton, OH

... closely monitored and managed to ensure that CareSource receives the highest quality of products ... in the IP Minimize financial risks to CareSource Confer with Treasury regarding capital expenditures ...

Pharmacy Knowledge Specialist

CareSource - Dayton, OH

Identify, develop and design information for the pharmacy training repository in Pharmacy Operations Collaborate with other departments, as necessary, to develop and/or review cross-functional ...

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