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AI Compliance Analyst II - Healthcare preferred

Role overview

Summary

The AI Compliance Analyst II role focuses on developing and optimizing AI solutions to enhance business processes within CareSource. You will work closely with stakeholders to ensure that AI implementations align with governance requirements and deliver measurable business value.

Qualifications

  • Bachelor's degree in a related field or equivalent relevant work experience.
  • Three (3) years of experience in healthcare operations, business analysis, automation, digital transformation, or technology solutions.
  • Experience with AI-enabled tools, digital engagement, automation, or conversational technologies.
  • Understanding of generative AI tools, AI agents, and large language model behavior.
  • Preferred: Proficiency with Microsoft Office tools, including Word, Excel, PowerPoint, Outlook, and Teams.

Responsibilities

  • Develop, configure, and optimize AI solutions and agents that support business processes.
  • Evaluate and optimize AI solution behavior and identify opportunities for configuration improvements.
  • Monitor metrics and business outcomes related to AI solutions.
  • Collaborate with technical, governance, compliance, and business partners to support responsible use and enhancement of AI solutions.

Key facts

  • Remote from: United States
  • Full time
  • Mid-level (2-5 years)
  • Compliance Analyst
  • $72K – $116K / year
  • English

Hard skills

Other skills

  • Analytical Skills
  • Problem Solving
  • Communication
  • Collaboration
  • Critical Thinking
  • Adaptability

About the company

CareSource logo

CareSource

  • Health Insurance & Payers
  • Large
  • 1,001–5,000
Health Care with Heart. It is more than a tagline; it’s how we do business. CareSource has been providing life-changing health care to people and communities for nearly 30 years and we will continue to be a transformative force in the industry by placing people over profits. CareSource is and will always be members first. Even as we grow, we remember the reason we are here – to make a difference in our members’ lives by improving their health and well-being. Today, CareSource offers a lifetime of health coverage to nearly 2 million members through plan offerings including Marketplace, Medicare Advantage and Medicaid. With our team of 4,000 employees located across the country, we continue to clear a path to better life for our members. Visit the "Life" section to see how we are living our mission in the states we serve. CareSource is an equal opportunity employer and gives consideration for employment to qualified applicants without regard to race, color, religion, sex, age, national origin, disability, sexual orientation, gender identity, genetic information, protected veteran status or any other characteristic protected by applicable federal, state or local law. If you’d like more information about your EEO rights as an applicant under the law, please click here: https://www.eeoc.gov/employers/upload/poster_screen_reader_optimized.pdf and here: https://www.dol.gov/ofccp/regs/compliance/posters/pdf/OFCCP_EEO_Supplement_Final_JRF_QA_508c.pdf Si usted o alguien a quien ayuda tienen preguntas sobre CareSource, tiene derecho a recibir esta información y ayuda en su propio idioma sin costo. Para hablar con un intérprete, Por favor, llame al número de Servicios para Afiliados que figura en su tarjeta de identificación. 如果您或者您在帮助的人对 CareSource 存有疑问,您有权 免费获得以您的语言提供的帮助和信息。 如果您需要与一 位翻译交谈,请拨打您的会员 ID 卡上的会员服务电话号码。

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Job description

Job Summary:

The AI Compliance Analyst II is responsible for developing, configuring, and optimizing AI solutions and agents that support business processes and operational objectives. This role serves as a trusted partner to stakeholders by identifying opportunities for AI enablement, recommending improvements, and ensuring solutions deliver measurable business value while aligning with governance requirements.

Essential Functions:

  • Designs, builds, and administers moderately complex AI solutions and agents using Copilot, Copilot Studio, Power Automate, Nintex and other approved tools.
  • Provides ongoing oversight of AI solutions at the business level.
  • Evaluates and optimizes AI solution behavior and identifies opportunities for configuration improvements.
  • Monitors metrics and business outcomes.
  • Performs testing, validation, and quality review of AI solution outputs to ensure accuracy, usability, and alignment with expected business outcomes.
  • Maintains documentation related to AI solution configuration, workflows, prompts, user guidance, and performance observations.
  • Collaborates with technical, governance, compliance, and business partners to support responsible use, adoption, and ongoing enhancement of AI solutions.
  • Perform any other job related duties as requested.


Education and Experience:

  • Bachelor's degree in a related field required
  • Equivalent years of relevant work experience may be accepted in lieu of required education
  • Three (3) years of experience in healthcare operations, business analysis, automation, digital transformation, technology solutions, or a related field required
  • Experience to include a background in AI-enabled tools, digital engagement, automation, or conversational technologies required
  • Experience setting up or improving service journeys, knowledge resources, workflows, or AI-enabled experiences in a cross-functional environment preferred
  • Experience in healthcare, health insurance, or another regulated industry is preferred

Competencies, Knowledge and Skills:

  • Understanding of generative AI tools, AI agents, large language model behavior, prompt patterns, agent instructions, model limitations, knowledge retrieval, and evaluation methods
  • Aptitude for designing AI-enabled healthcare service experiences, customer or employee journeys, conversational flows, and operational workflows
  • Ability to translate complex healthcare operation’s needs into clear AI experience designs, prompts, agent instructions, business requirements, acceptance criteria, and quality standards
  • Ability to support testing, validation, and quality review of AI solution outputs to ensure accuracy, usability, and alignment with expected business outcomes
  • Analytical, critical thinking, problem-solving, facilitation, communication, and documentation skills
  • Knowledge of responsible AI principles, privacy considerations, accessibility, security, risk controls, and human-in-the-loop review practices
  • Ability to establish and maintain effective working relationships with cross-functional stakeholders
  • Ability to manage multiple assignments, prioritize work, meet deadlines, and adapt in a fast-paced environment
  • Proficiency with Microsoft Office tools, including Word, Excel, PowerPoint, Outlook, Teams, and related collaboration tools
  • Working knowledge of Nintex Workflows

Licensure and Certification:

  • None

Working Conditions:

  • General office environment; may be required to sit or stand for extended periods of time
  • Travel is not typically required

Compensation Range:

$72,200.00 - $115,500.00

CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package.

Compensation Type (hourly/salary):

Salary

Organization Level Competencies

  • Fostering a Collaborative Workplace Culture

  • Cultivate Partnerships

  • Develop Self and Others

  • Drive Execution

  • Influence Others

  • Pursue Personal Excellence

  • Understand the Business

This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.

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