The Scrum Product Owner fulfills the role of Scrum Product Owner as defined by the principles of Scrum to maximize the value of the IT product and work of the development team. Essential Functions Develop the strategic vision for an IT product Work closely with the Scrum team to maintain focus on goals, alignment with business needs and urgent matters, and adherence to st

The Enterprise Accreditation Specialist III is responsible for supporting the organization to obtain and maintain appropriate accreditations, distinctions and recognitions through NCQA, URAC or other accrediting bodies. This person will serve as the subject matter expert for various accreditations, including but not limited to NCQA Health Plan Accreditation, LTSS Distinct

The Special Investigations Unit (SIU) III is responsible for investigating and resolving high complexity allegations of healthcare fraud, waste and abuse (FWA) by medical professional, facilities, and members. Researches, gathers, and analyzes data to identify trends, patterns, aberrancies, and outliers in provider billing behavior. Serves as a subject matter expert for o

The Operations Specialist II provides analytical support and leadership for project impacting Claims and key internal Claims projects. Essential Functions Represent claims on cross functional project work teams Submit, monitor and prioritize IT tickets for the Claims department Review special projects and identify issue trends and potential resolutions Assist with Onbase

The Operations Specialist II provides analytical support and leadership for project impacting Claims and key internal Claims projects. Essential Functions Represent claims on cross functional project work teams Submit, monitor and prioritize IT tickets for the Claims department Review special projects and identify issue trends and potential resolutions Assist with Onbase

The Member Health Assessor engages with the member to establish an effective, professional relationship with primary responsibility to conduct a standardized Health Risk Appraisals (HRA). Essential Functions Verify eligibility, previous enrollment history, demographics and current health status of each member prior to outreach Engage the member to gather information to as

The Distribution and Processing Services Specialist I is responsible for all incoming and outgoing mail service functions including processing registered, certified, and overnight mail. This position works full time in office at our Dayton HQ. Essential Functions Receive, open, sort, and distribute incoming mail to all departments, multiple buildings in Dayton and regiona

The Compliance Analyst II position is a professional compliance role responsible for supporting the Compliance Program by collaborating and overseeing high risk areas to ensure that the compliance program is effective and efficient in identifying, preventing, detecting, and correcting noncompliance. Essential Functions Provide Compliance Program support with audit and mon

The Sales Coordinator II, in collaboration with team members and leadership, supports the sales strategy and sales enrollment initiatives to ensure annual sales goals are successfully achieved. Essential Functions Work with Leadership to provide support for the internal systems tracking of sales and commissions Manage daily onboarding of agents including validation of com

The Life Services Life Coach provides one on one coaching and development for participants in the Life Services program as defined by member needs both urgent, immediate, and long term to prepare members for employment or education programs and assist them with social determinants of health (SDOH) needs. Essential Functions Complete required assessments by gathering infor

The Operations Specialist II provides analytical support and leadership for project impacting Claims and key internal Claims projects. Essential Functions Represent claims on cross functional project work teams Submit, monitor and prioritize IT tickets for the Claims department Review special projects and identify issue trends and potential resolutions Assist with Onbase

The Internal Auditor II works in a self directed team environment to execute internal audits as defined by management and the Audit Committee with progressive latitude for team goal setting, initiative and independent judgement on collective work products. The auditor works to identify and evaluate organizational risk, recommends and monitors mitigation action and support

The AVP, Finance is responsible for providing financial oversight, leadership and support to the market/corporate and ensures the department proactively collaborates with and provides support for analyses being conducted by areas outside the Finance Department. Essential Functions Manages the execution of the annual budget/quarterly forecast including detailed development

Member Engagement Analyst II is responsible for contributing to the overall support of Member Engagement programs by coordinating processes and procedures associated with benefits, retention and member engagement. Essential Functions Support work groups and initiatives for incentive and rewards Supports Consumer Council Meetings (external) Supports the implementation and

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