Care Compliance & Integrated Care Operations Manager

CareSource; Ohio; On-site; USD 94,000 - 165,000; Full time

Job summary

CareSource seeks a Manager, Integrated Care Waiver Operations to lead regulatory reporting, audits, and compliance for Medicare and Medicaid programs. You will oversee Care Management operations, drive quality outcomes and process improvements through data analysis and cross-functional collaboration.

The role focuses on ensuring adherence to state and federal requirements, developing action plans, and guiding staff toward efficient, compliant service delivery.

Qualifications

• Bachelor's degree required in relevant field
• Two years of health care experience required
• Experience with HCBS programs preferred
• Previous management experience required

Responsibilities

• Lead CMS, ODM and regulatory reporting on a monthly, quarterly and yearly basis
• Develop and implement action plans from regulatory feedback
• Oversee Care Management operations ensuring quality outcomes and compliance
• Conduct monthly/quarterly quality reviews with Operations and Case Management
• Collaborate across departments to drive process improvements

Skills

Leadership

Regulatory reporting

Data analysis

Project management

Communication

Healthcare knowledge

Audits & compliance

Cross-functional collaboration

Education

Bachelor's degree in Business Administration, Health Care or related field

Two years of health care experience

Managed care, Medicaid Billing or JFS experience preferred

Tools

Excel

Word

PowerPoint

Job description

CareSource seeks a Manager, Integrated Care Waiver Operations to lead regulatory reporting, audits, and compliance for Medicare and Medicaid programs. You will oversee Care Management operations, drive quality outcomes and process improvements through data analysis and cross-functional collaboration.

The role focuses on ensuring adherence to state and federal requirements, developing action plans, and guiding staff toward efficient, compliant service delivery.