Job Summary: The Medical Director is responsible for supporting staff by providing training, clinical consultation, and clinical case review for members. Essential Functions: Provide prior authorization medical reviews, consultation and clinical review services Participate in peer-to-peer
Job Summary: The Enterprise Quality Statistician leads, implements, and conducts analysis for quality and performance improvement and population health processes through the integration of quality improvement science and advanced statistical methodologies. Essential Functions: Serve as the
Job Summary: The Medical Director, Neonatology is responsible for providing subject matter expertise and medical leadership in the development of utilization management, care management and quality of care programs for infant and neonatology services. Essential Functions:
Company Description INSPIRING A BETTER WAY OF LIVING ACCESSIBLE TO ALL As the preferred partner for window and door automation, SOMFY is committed to inspiring new and better ways of living for all. As a French,
Job Summary: The Integrated Care Program Manager is responsible for managing large-scale portfolio programs aligned to strategic objectives that include multiple projects. Essential Functions: Responsible for successful delivery of LTSS and Dual Eligible programs Understand the
Job Summary: The Data Scientist III is responsible for designing and validating predictive models, machine learning models, and artificial intelligence that inform and improve business processes across the organization (operational, clinical, financial, marketing, etc.). Essential Functions:
Job Summary: The Data Solutions AI Application Developer III is responsible for designing and rapidly deploying lightweight applications and user interfaces to operationalize advanced AI solutions, including generative AI (LLM-based), agentic AI, and NLP-driven capabilities—across the
Internship Program The CareSource Intern is responsible for providing support on special projects, initiatives, and specific activities which will vary by assignment. We offer a 12-week, paid summer internship program for college students who want to
Job Title: AI/ML Engineer Location: Dayton, OH Employment Type: Full-Time Clearance requirements: TS/SCI About the Role Rackner is seeking a highly skilled AI/ML Engineer to design, develop, and deploy advanced machine learning solutions that support mission-critical
Job Summary: The Director, Quality Enterprise Strategy is responsible for leading the execution, performance management, and regulatory compliance of CareSources quality programs. This role oversees quality performance, operational readiness, regulatory adherence, and quality performance improvement initiatives
Job Summary: The LTSS & Dual Eligible Report Engineer IV will play a crucial role in utilizing data analytics to drive informed decision-making and optimize business processes within the healthcare environment. This senior-level position is responsible
Job Summary: The Clinical Operations Program Manager – UM Operations & Clinical Appeals is responsible for managing and coordinating operational projects or initiatives that support Utilization management (UM) and/or Clinical Appeals, market readiness activities, workflow improvements,
Job Summary: The Clinical Operations Program Manager – UM Operations & Clinical Appeals is responsible for managing and coordinating operational projects or initiatives that support Utilization management (UM) and/or Clinical Appeals, market readiness activities, workflow improvements,
Job Summary: The Associate Vice President, Integrated Care Management Operations - MA collaborates closely with both Market and Corporate Leadership to ensure the effective delivery of integrated care services across multiple high-volume membership markets and/or markets