Director, Integrated Care Waiver Operations

CareSource; United States; Remote; USD 94,000 - 165,000; Full time

Job summary

CareSource is seeking a Manager, Integrated Care Waiver Operations to provide strategic leadership of operations staff and drive compliance with CMS, ODM, and state requirements. You will oversee reporting, audits, and quality initiatives to improve member outcomes and efficiency, coordinating with IT, Provider Relations, and Case Management teams.

The role emphasizes program development, data-driven decision making, and cross-functional collaboration to optimize care management and regulatory

Qualifications

• Bachelor’s degree in Business Administration, Health Care or other related field required.
• Two years of health care experience required.
• Experience in HCBS programs preferred.
• Previous management experience required.
• Managed care, Medicaid Billing and/or JFS Program experience preferred.

Responsibilities

• Lead regulatory reporting for CMS, ODM and state programs.
• Oversee audit preparation and presentation for Medicare and Medicaid.
• Develop action plans in response to regulatory feedback on reporting and/or audits.
• Ensure safe, effective service delivery and compliance.
• Monitor and report on program performance and cost savings.
• Collaborate cross-functionally to drive process improvements.

Skills

Microsoft Office

Written & Verbal Communication

Analytical Skills

Cross-Functional Collaboration

Problem Solving

Education

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

Two years of health care experience

Managed care, Medicaid Billing and/or JFS Program experience preferred

Job description

CareSource is seeking a Manager, Integrated Care Waiver Operations to provide strategic leadership of operations staff and drive compliance with CMS, ODM, and state requirements. You will oversee reporting, audits, and quality initiatives to improve member outcomes and efficiency, coordinating with IT, Provider Relations, and Case Management teams.

The role emphasizes program development, data-driven decision making, and cross-functional collaboration to optimize care management and regulatory