Team Lead, Integrated Care Coordination - Waiver

Team Lead, Integrated Care Coordination - Waiver, serves as a working leader responsible for both the day-to-day operational support of assigned Care Coordinators and the direct management of a reduced caseload of MyCare HCBS Waiver members.

Responsibilities

• Provide day-to-day oversight and direction to assigned Care Coordinators.
• Monitor daily operational workflows and ensure timely completion of assessments, service plans, contacts, authorizations, and member outreach activities.
• Serve as the first level escalation point for staff questions, barriers, member concerns, and operational issues.
• Facilitate team huddles, case reviews, and workload discussions.
• Assist with caseload balancing and workload distribution.
• Provide consultation regarding HCBS Waiver requirements, service planning, person-centered planning, care coordination, and service delivery.
• Assist staff with complex member situations, transition planning, service gaps, provider issues, and member health and welfare concerns.
• Support implementation of care plans and service plans in accordance with MyCare HCBS Waiver requirements.
• Assist staff with identifying community resources and supports to address member needs.
• Support continuity of care activities during transitions between settings, providers, programs, and care coordinators.
• Conduct routine documentation audits and quality reviews.
• Monitor compliance with assessment, service planning, and outreach timeframes.
• Identify trends, risks, and compliance concerns and escalate to the Manager.
• Assist in preparation of corrective action activities and quality improvement initiatives.
• Monitor adherence to policies, procedures, workflows, regulatory requirements, and operational expectations.
• Coach, mentor, and develop assigned Care Coordinators, providing real-time feedback and performance coaching.
• Partner with the Manager regarding performance concerns, training opportunities, and professional development needs.
• Assist with onboarding and training of new staff and support annual competencies and ongoing staff education initiatives.
• Partner with providers, Community Partners, delegates, vendors, and internal departments to support member needs.
• Participate in interdisciplinary meetings, operational workgroups, and stakeholder meetings as assigned.
• Serve as a resource regarding HCBS Waiver program requirements and operational processes.
• Maintain a reduced caseload as assigned.
• Serve as the primary coordinator or consultant for high-risk members, members with repeated incidents, complex transition cases, members requiring multidisciplinary intervention, members experiencing service gaps, or members with significant social determinants of health challenges.
• Perform any other job-related duties as requested.

Requirements

• Associate's degree in healthcare required; Bachelor's degree in Nursing, Social Work, Human Services, Healthcare Administration, or related field preferred.
• Three (3) years of care management, care coordination, HCBS Waiver, LTSS, Medicaid, or managed care experience required.
• Prior leadership experience is preferred.
• Current, unrestricted Registered Nurse (RN) license in state of practice or current, unrestricted Licensed Social Worker (LSW) in state of practice is required.
• Case Management certification preferred.
• Must have valid driver’s license, vehicle, and verifiable insurance. Employment in this position is conditional pending successful clearance of a driver’s license record check.
• Influenza vaccination is required annually (October 1 – March 31) as a condition of continued employment.

Skills

• Strong knowledge of MyCare HCBS Waiver and LTSS programs.
• Knowledge of person-centered service planning principles.
• Understanding of Ohio Medicaid, waiver requirements, and managed care operations.
• Strong coaching and mentoring skills.
• Strong organizational and problem-solving abilities.
• Ability to manage competing priorities in a fast-paced environment.
• Strong written and verbal communication skills.
• Ability to analyze performance and quality data.
• Proficient in Microsoft Office applications.

Pay

$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.

Benefits

We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package.

Schedule

• General office environment; may be required to sit or stand for extended periods of time.
• Up to 25% (regular) travel may be required to travel to different locations, including homes, offices, or other public settings, to perform work duties.