Integrated Care Coordination Team Lead - Member Outcomes

CareSource; Alabama; Sur place; USD 72 000 - 116 000; Plein temps

Résumé du poste

CareSource is seeking a Team Lead for Integrated Care Coordination - Waiver to oversee Care Coordinators and manage a reduced caseload of MyCare HCBS Waiver members. You will escalate clinical and operational issues and help achieve program goals and member outcomes.

You will guide staff, ensure timely assessments and service plans, and coordinate with providers and partners to close gaps in care while maintaining compliance with waiver requirements.

Qualifications

• Bachelor's degree in Nursing, Social Work, Human Services, Healthcare Administration or related field.
• Three (3) years of care management, care coordination, HCBS Waiver, LTSS, Medicaid, or managed care experience required.
• Knowledge of person-centered service planning principles.
• Understanding of Ohio Medicaid, waiver requirements, and managed care operations.
• Proficiency in Microsoft Office applications.

Responsabilités

• 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.
• 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.
• Partner with providers, Community Partners, delegates, vendors, and internal departments to support member needs.
• 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.

Connaissances

Care coordination

Coaching

Communication

Formation

Bachelor's degree in Nursing, Social Work, Human Services, Healthcare Administration

Outils

MS Office

Description du poste

CareSource is seeking a Team Lead for Integrated Care Coordination - Waiver to oversee Care Coordinators and manage a reduced caseload of MyCare HCBS Waiver members. You will escalate clinical and operational issues and help achieve program goals and member outcomes.

You will guide staff, ensure timely assessments and service plans, and coordinate with providers and partners to close gaps in care while maintaining compliance with waiver requirements.