Microsoft AI drives greater efficiency and a human touch in CareSource member experience

Mission-driven growth meets modern infrastructure

CareSource is dedicated to transforming health care for those served by government-sponsored health care programs like Medicare, Medicaid, and Marketplace. The company administers one of the largest Medicaid managed care plans in the United States and serves more than two million members across multiple states. As it expands into new markets, CareSource remains anchored in its founding principle: providing health care with heart.

This mission-driven mindset shapes business decisions, especially as CareSource refines and scales its operations. “The decisions we make have to serve our members and our mission,” says Devon Valencia, Chief Information Officer at CareSource. “It’s not just about efficiency; it’s about human dignity and human oversight.”

Rapid growth has brought greater complexity: a broader footprint, more members, and increasing demand for timely, personalized service. To keep pace without losing the human touch, CareSource needed to enhance systems, reduce manual effort, and give employees tools that boost their impact in service to members.

“We have a tremendous opportunity to apply artificial intelligence, allowing our employees to spend more time serving our members,” says Todd Carlson, Senior Vice President, Enterprise Engineering Solutions. “We’re growing quickly, and this is about scaling smartly to bring our unique brand of care to more people, not just get bigger.”

“For me, the most interesting part is how many people are benefiting from AI as we go on this journey,” adds Valencia. “It's really a diverse set of people. Everyone from our call center agents to our technology experts to our analytics teams, who are trying to find trends and population data—the possibilities are endless.”

Building a modern AI-powered platform

Over the past 18 months, CareSource has partnered with Microsoft to reimagine its technology foundation, leveraging Azure OpenAI Service for language-based automation, Azure Functions and Cosmos DB to power scalable backend workflows, and Dynamics 365 to enhance service operations and streamline member support. They’ve adopted Azure Virtual Desktop to reduce infrastructure costs and improve remote access, and GitHub Copilot to boost developer productivity.

“The reason we chose Microsoft is because we wanted a secure solution,” says Carlson. “In the health care industry, member data is very important, and protecting CareSource’s member data is key.”

Layered on top of that is a growing suite of internal AI tools, including CareSource GPT and a proprietary tool built to surface insights and improve care coordination and member experiences while providing employees with opportunities to innovate using AI. What began with simple process enhancements has evolved into a suite of enterprise-ready tools for employees and members alike.

CareSource MyLife is a next generation digital companion reshaping the future of personalized digital health care. As a single-point solution focused on access, community, and personalization, CareSource MyLife provides uniquely tailored experiences designed to empower both members and caregivers throughout their health journey—for life.

“AI allows us to surface what we need so we can focus on what really matters: our members,” says Rob Garretson, Senior Director of Application Development, Enterprise Architecture at CareSource. “We’re incorporating more artificial intelligence into the MyLife platform. We’re already advancing a use case where artificial intelligence translates a member’s description of the kind of doctor they need into the correct medical specialty.”

CareSource takes a disciplined, human involved, and governance-first approach to AI, with each initiative evaluated by a cross-functional employee leadership council spanning across Security, Privacy, Ethics, IT, Infrastructure, Risk, Legal, Architecture, Audit, Compliance, Operations, Clinical, and HR departments.

Use cases are prioritized based on impact and undergo rigorous reviews to ensure data quality, human oversight, and real-world value, especially in sensitive areas like clinical and claims data where AI is never used to make final coverage or clinical decisions. This intentional model has become a cultural pillar, ensuring AI is implemented with care, transparency, and accountability.

“Having those OpenAI models on Azure enables us to safely interact in a way that is covered by our data agreements with Microsoft,” says Garretson. “That allows us to protect our members’ sensitive information and the rest of CareSource’s data.”

The result is a more connected, more compassionate system powered by data, but driven by people.

Delivering results that are faster, smarter, and more human

Internally, the AI rollout has created a wave of empowerment. Developers using GitHub Copilot report significant productivity gains, freeing them from boilerplate code and repetitive tasks so they can focus on architecture and innovation. 

Employees at all levels are benefiting from CareSource’s AI tools, improving speed and quality of work while reducing overall costs. Administrative staff uses AI to summarize documents, extract insights, and automate routine tasks, turning what used to be days of work into hours.

“AI can help make us faster and smarter," says Garretson. "But it’s the people behind the AI that serve our members day in and day out, that’s what makes us human and what truly sets CareSource apart.” 

The implementation of Microsoft Azure OpenAI at CareSource has already delivered measurable results. A key documentation process that previously took two months has now been reduced to just two weeks. One automation initiative alone has saved the organization over $125,000. Additionally, developers using GitHub Copilot have reported productivity gains ranging from 20% to 30%. These improvements are not just theoretical—they’re being felt directly by frontline teams, where speed, efficiency, and impact matter most.

“This is not about cutting resources. It’s about freeing up our smart, capable employees from repetitive work so they can enable us to scale innovatively,” says Carlson. 

Expanding with intelligence and integrity

CareSource is strategically positioned for continued growth and innovation, supported by a modern, cloud-first infrastructure and a strong foundation of responsible AI. The organization is prioritizing several initiatives, including expanding the use of Dynamics 365 to enhance marketing and engagement, launching Copilot capabilities to streamline agent workflows, improving provider recommendations for specialty care, and continuing the migration of on-premises infrastructure to Azure to enable future innovation. Throughout this journey, Microsoft remains a trusted partner. “Microsoft feels like part of the team,” says Carlson. “Their partnership has been critical in helping us do this responsibly.”

“Our Microsoft account team has been great, super supportive through the entire journey,” says Garretson. “They’re always guiding us towards the right solutions, giving us suggestions on how we should build things, and hosting insightful collaboration.”  That collaboration extends into deeper integrations across the Microsoft ecosystem. CareSource is currently piloting tools that use conversational AI to help summarize unstructured data, saving time for clinical teams and improving care quality. Additional efforts focus on AI-assisted triage, surfacing urgency cues and red flags to help human agents respond to member needs faster and more effectively.  

”The Microsoft partnership for us has been hugely valuable,” adds Valencia. “At the end of the day, we're really focusing on delivering health care with heart. That means making sure our employees can do their jobs the best way they possibly can.”

“This is what transformation looks like when it’s guided by values and powered by the right tools,” says Garretson. “Together, we’re building a more human future for health care.”