Clinical Care Reviewer II is responsible for processing medical necessity reviews for appropriateness of authorization for health care services, assisting with discharge planning activities (i.e. DME, home health services) and care coordination for members, as well as monitoring the delivery of healthcare services. Essential Functions Complete prospective, concurrent and

Commonwealth Care Alliance (CCA) is a nonprofit, mission driven health plan and care delivery organization designed for individuals with the most significant needs. As an affiliate of CareSource, a nationally recognized nonprofit managed care organization with over 2 million members across multiple states, CCA serves individuals enrolled in Medicaid and Medicare in Massac

The Data Engineer II is responsible for contributing to team and department solution design architecture, and the development and implementation of appropriate standards and strategies for all sources of data. Essential Functions Key contributor for data stewardship workgroups and teams in data management and governance activities Be a champion or ambassador of metadata a

The IT Financial Analyst III is responsible for the leading development of expense projections to support forecast and budget and monitor monthly variances to identify trends in IT. Essential Functions Prepares monthly IT department analysis and reports to maintain expenditure controls and to identify trends affecting financial needs Prepare integrated financial analysis

The Team Lead, Customer Care is responsible for leading and directing their team to ensure goals, regulatory, compliance, and department standards are met. Essential Functions Conduct regularly scheduled coaching conversations; listening and providing feedback for improved performance, and when applicable, create performance improvement plans Properly document coaching an

The AI Engineer III is the lead builder of the "Engine Room," responsible for the reliability, scalability, and observability of the Pantheon AI Mesh and Azure AI Foundry stack. This role designs and maintains the CI/CD pipelines for models and agents, ensuring that AI solutions are deployed securely, monitored for drift, and can be rolled back instantly if issues arise.

The AI Solution Consultant serves as the primary "Face of AI" for CareSource business units, acting as a strategic bridge between clinical/operational domains and the technical AI Platform team. This role is responsible for driving the enterprise wide intake and triage process, stratifying opportunities into Green (Self Service), Yellow (Citizen Dev), and Red (Pro Code) t

The AI Systems Analyst III provides the technical and analytical rigor behind the intake and triage process. Working within the CoE, this role analyzes business requirements against technical capabilities, ensuring that data readiness, lineage, and architectural fit are validated before a project enters the build phase. They maintain the enterprise AI Registry, serving as

ElderServe Health is a mission driven, nonprofit managed care organization serving the New York metropolitan area. ElderServe provides long term services and supports to more than 20,000 older adults and adults with disabilities across New York City, as well as Westchester, Nassau, and Suffolk Counties. ElderServe primarily serves a frail and elderly membership who is pre

The Community Based 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 through culturally competent delivery of care and coordination of services and supports. Facilitates communication, coordinates c

The Community Based 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 through culturally competent delivery of care and coordination of services and supports. Facilitates communication, coordinates c

The Community Based 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 through culturally competent delivery of care and coordination of services and supports. Facilitates communication, coordinates c

The Community Based 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 through culturally competent delivery of care and coordination of services and supports. Facilitates communication, coordinates c

The Community Based 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 through culturally competent delivery of care and coordination of services and supports. Facilitates communication, coordinates c

ElderServe Health is a mission driven, nonprofit managed care organization serving the New York metropolitan area. ElderServe provides long term services and supports to more than 20,000 older adults and adults with disabilities across New York City, as well as Westchester, Nassau, and Suffolk Counties. ElderServe primarily serves a frail and elderly membership who is pre