CareSource · 5 months ago
LTSS Provider Network Operations Analyst II- MUST RESIDE IN THE STATE OF OHIO!
Ohio Mobile
Full-time
Hybrid
Entry, Mid Level
$63K/yr - $100K/yr
2+ years expCareSource is a health care management organization that focuses on providing quality services to its members. The LTSS Provider Network Operations Analyst II is responsible for executing project plans and business analysis to support the LTSS & HCBS provider network and ensure compliance with regulatory requirements.
Health CareMedicalNon Profit
Responsibilities
Analyze data, workloads, and processes to enhance operations efficiencies in support of LTSS & HCBS providers
Identify trends and solutions to operational support and ensure provider adherence to regulatory and contractual requirements
Perform quality assurance reviews to ensure that provider information is loaded correctly, and contracting terms are accurately operationalized
Assist with research and resolution of provider inquiries and provide a professional and comprehensive response to providers and other stakeholders as required
Improve Electronic Visit Verification compliance rates for provider network
Perform virtual initial onboarding and ongoing education to provider network
Manage online communications and optimize service delivery and provider experience
Assist with network adequacy requirements through analysis and service delivery resulting in provider retention
Responsible for understanding regulations changes and monitoring LTSS and HCBS provider network for compliance
Partner with leadership within business area to prioritize opportunities to achieve department and organizational goals
Support LTSS updates via network notifications, virtual townhalls, and direct interactions
Recognize and proactively identify operational dependencies and process improvements
Develop and maintain dashboard reporting for leadership
Produce detailed reports and business decision documents
Develop and maintain an in-depth knowledge of the company’s business and regulatory environments
Perform any other job-related instructions, as requested
Qualification
Required
Bachelor of Science/Arts degree or equivalent years of relevant work experience is required
Minimum of three (2) years of business management or health care operations experience in insurance, managed care, or related industry is required
Minimum of two (2) years Provider Relations experience is required
Advanced knowledge of Medicaid, Medicare, MyCare, LTSS, HCBS, and Ohio Home Care Waiver is required
Proficient in Microsoft Office Suite to include Word, Excel and PowerPoint
Proficient in data analysis
Effective identification of business problems, assessment of proposed solutions to those problems, and understanding of the needs of business partners
Proven experience with project management tools and resolution of open issues
Ability to execute small to medium scope project plans including business requirements gathering, definition/prioritization, project scope definition, training, and documentation
Comprehensive knowledge of project methodology, scheduling, and forecasting skills
Excellent written and verbal communication and interaction skills
Knowledge of regulatory reporting and compliance requirements
Effective problem-solving skills with attention to detail
Ability to develop, prioritize and accomplish goals
Employment in this position is conditional pending successful clearance of a driver's license record check
To help protect our employees, members, and the communities we serve from acquiring communicable diseases, Influenza vaccination is a requirement of this position
Reside in the state of Ohio
May be required to travel greater than 50% of time to perform work duties
A valid driver's license, car, and insurance are necessary for work related travel
Preferred
Minimum of two (2) years of experience in leading business initiatives to drive systemic change is preferred
Benefits
You may qualify for a bonus tied to company and individual performance.
Substantial and comprehensive total rewards package.
Company
CareSource
CareSource provides managed care services to Medicaid beneficiaries.
1001-5000 employees
H1B Sponsorship
CareSource has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (30)
2024 (39)
2023 (35)
2022 (21)
2021 (37)
2020 (28)
Funding
Current Stage
Late StageTotal Funding
unknownKey Investors
FHLB Cincinnati
2026-01-17Grant
Leadership Team
Erhardt Preitauer
President & Chief Executive Officer
Jason Bearden
Market President and CEO, Georgia
Recent News
2026-01-18
Dayton Daily News
2025-12-17
Company data provided by crunchbase