The Data Governance Practice Lead III develops, implements, and maintains Enterprise Data Governance Value Stream road maps, strategic and tactical plans in alignment with the overarching Enterprise Data Governance program. Essential Functions Accountable for the successful delivery the assigned Enterprise Data Governance Value Stream Work with appropriate business stakeh

The Leadership Coach IV provides one on one coaching for Directors and Vice Presidents to accelerate their transition to their new role as well as facilitate executive level learning, group/team coaching and/or strategy sessions. Essential Functions Provide leadership development, transition, high potential and succession coaching, with a specific focus on coaching Direct

The OHCW Community Based Care Manager is responsible for working with adult individuals and their care team to develop a person centered care plan to address their home and community based needs, and collaborates with members of an inter disciplinary care team (ICT) to meet the needs of the individual and the population, identifying problems or opportunities that would be

The Senior Manager, Technical Claims Adjustments is responsible for providing leadership and direction to employees in the Claim Adjustment department to ensure the goals and standards of the department and CareSource are met. Essential Functions Provide leadership and direction to employees in the Claim Adjustment department to ensure the goals and standards of the depar

The Guiding Care Systems Analyst Lead is responsible for leading research and analysis to identify systems impacted by requirements, possible interfaces, cross team dependencies and affected lines of business. Essential Functions Review Upgrade Release notes from a Software as a Solution system, Guiding Care, to create testable stories Recommend best practice solutions fo

The Medicare Sales Representative II is responsible for supporting the sales strategy and enrollment goals in collaboration with management to ensure goals are successfully achieved for the Medicare Advantage product line within an assigned territory and consistent with state and federal regulations. Essential Functions Contribute and support the development of educationa

The Medicare Sales Representative II is responsible for supporting the sales strategy and enrollment goals in collaboration with management to ensure goals are successfully achieved for the Medicare Advantage product line within an assigned territory and consistent with state and federal regulations. Essential Functions Contribute and support the development of educationa

The Quality Analyst II is responsible for analyzing and interpreting complex healthcare data. This role will collaborate with cross functional teams, providing analytical insight to inform strategy and interventions to drive improved quality performance. HEDIS and Healthcare Experience Strongly Preferred Essential Functions Generate graphics that effectively describe, exp

The Digital Product Content Manager orchestrates and delivers a cohesive experience for users (e.g. members, providers, etc.) within, and across, digital assets (e.g. Member Portal, Provider Portal). Responsibilities include identifying target audiences, preferences, and content that resonates; planning and producing high quality content, defining content workflows and op

The Pharmacist Clinical Strategy Manager is responsible for oversight of clinical pharmacy activities, formulary and specialty/ medical drug management, ensuring consistency in delivery of services and achievement of utilization targets. Essential Functions Coordinate the implementation and execution of the Clinical Strategy, Formulary Strategy, and Medical Drug team init

Pharmacist I is responsible for supporting the department, operational strategies, goals and vision. Pharmacists shall utilize pharmaceutical and clinical expertise to review Prior Authorizations requests within a timely manner, to promptly serve our CareSource members. Essential Functions Supports and participates in Prior Authorization (PA) Reviews by documenting, imple

The Data Product Manager III will drive the strategy for how to leverage data and deliver exceptional new digital experiences and insights by providing trusted, accurate data insights that drive action, measure impact, and proactively create measurable improvement across member/provider digital platforms. Essential Functions Responsible for driving business results and em

The Growth Product Manager III will drive the strategy for growing our Marketplace, B2C member acquisition and retention strategies. This role will conduct user research, understand buyer behaviors, and leverage third party tools across the whole user journey to create a seamless experience and consistently analyze on how to improve the use of tools to increase customer l

The Care Manager collaborates with members of an inter disciplinary care team (ICT), providers, community and faith based organizations to improve quality and meet the needs of the individual, natural supports and the population with culturally competent delivery of care, services and supports. Facilitates communication, coordinates care and service of the member through

Must have NICU background along with Managerial background UM and CM background HIGHLY preferred as well The Manager, Utilization and Care Management provides operational management and oversight of all utilization and care management activities ensuring consistency of services and achievement of utilization targets to achieve optimal clinical, financial and quality of li