Integrated Care Program Operations Manager

CareSource; Town of Dayton (WI); Hybrid; USD 94,000 - 165,000; Full time

Job summary

CareSource is seeking an Integrated Care Program Operations Manager to assist the Duals team with ongoing design, standardization, and implementation efforts for the Dual eligible and LTSS model.

The role emphasizes collaboration across markets, translation of strategy into operational tactics, and leadership in executing high-quality, scalable initiatives within a healthcare insurance context.

Qualifications

• High School or GED required.
• Bachelor's degree preferred.
• Four (4) years of clinical operations/healthcare administration experience required.
• Four (4) years of experience driving performance and process improvements in health care insurance required.
• Three (3) years experience with Government-regulated health insurance products including Medicaid, Managed Care Waiver, FFS and Medicare preferred.
• Three (3) years experience implementing programs with focus on integration preferred.
• Three (3) years Project management experience preferred.

Responsibilities

• Collaborate with markets to implement business strategies and operational plans to ensure core functionality, scalability, and ongoing department management to support LTSS model.
• Translate business and program vision into operational tactics - collaborating to build necessary organizational support and infrastructure.
• Support post-implementation strategy and goals to mitigate program risks.
• Evaluate operational process effectiveness for market goals and objectives; manage operation process improvement activities with market teams.
• Coordinate and execute key strategies for functional/operational requirements.
• Provide leadership and support for product expansion.

Skills

Healthcare operations

Project management

Process improvement

Stakeholder communication

Leadership

Microsoft Office

Education

High School diploma or GED

Bachelor's degree preferred

Tools

Microsoft Project

Outlook

Word

PowerPoint

Excel

Job description

Job Summary: The Integrated Care Program Operations Manager assists the Duals team with open projects and progress towards completion, program enhancements, development, and execution activities related to implementation and ongoing design and standardization for the Dual eligible and LTSS model.

Essential Functions:

• Collaborate with markets to implement business strategies and operational plans to ensure core functionality, scalability, and ongoing department management to support LTSS (HCBS and NH) model
• Support the translation of business and program vision and strategy into operational tactics - collaborating to build the necessary organizational support and infrastructure
• Support post implementation strategy and goals to mitigate program risks
• Support the evaluation of operational process effectiveness for accomplishing market goals and objectives; manage operation process improvement activities in collaboration with market teams
• Coordinate, translate, and execute key strategies for functional/ operational requirements
• Provide leadership and support for product expansion
• Incorporates industry standard, best practice project management tools and techniques in market initiatives
• Recognizes and proactively manages operational dependencies and risks across market operations initiatives portfolio through effective change and risk management controls
• Works closely with leadership to establish, communicate, and perpetuate the corporate vision, ensuring appropriate communication to stakeholders
• Monitors performance across markets LTSSS/HCBS programs to leverage best practice and knowledge sharing for the purpose of improving outcomes through the standardization of evidence-based practices
• Assists the dual eligible President with the monitoring of legislative/governmental activities with the goal of advocating for the full integration LTSS/HCBS standard model, identifying opportunities and issues
• Interacts heavily within Dual Eligible, LTSS program business partners, and builds strong working relationships with all markets
• Engages stakeholders to ensure alignment
• Leads activities ensuring the delivery of high quality, consistent initiatives that result in optimum outcomes for members, providers, and program goals
• Perform any other job related duties as requested.

Education and Experience:

• High School or GED required
• Bachelor's degree preferred
• Four (4) years of clinical operations/healthcare administration experience required
• Four (4) years of experience driving performance and process improvements, is in the health care insurance industry required
• Three (3) years Experience with Government-regulated (Federal and/or State) health insurance products including Medicaid, Managed Care Waiver, FFS and Medicare preferred
• Three (3) years Experience implementing programs with focus on integration preferred
• Three (3) years Project management experience preferred

Competencies, Knowledge and Skills:

• Able to effectively identify business problems, assess proposed solutions, and understand the needs of business partners and stakeholders
• Ability to communicate effectively with all levels of leadership
• Develops effective working relationships with business partners and stakeholders
• Strong organizational, time management, analysis, and problem-solving skills
• Ability to manage a project from start to finish
• Strong relationship building skills and leadership qualities
• Training and teaching skills/change agent
• Ability to think critically and lead with strategy
• Comprehensive knowledge base crossing all the following areas: Clinical Operations, Market Groups, Business Development, Network, and Operations
• Hands on proficiency in Microsoft Office tools, including Project, Outlook, Word, PowerPoint, and Excel
• Business acumen and politically astute ability to act with diplomacy and sensitivity to cultural diversity

Licensure and Certification:

None

Working Conditions:

• General office environment; may be required to sit or stand for extended periods of time
• Up to 15% (occasional) travel based on the needs of the department may be required

Compensation

Range: $94,100.00 - $164,800.00 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. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package.

Compensation Type (hourly/salary)

Salary

Organization Level

Competencies Fostering a Collaborative Workplace Culture Cultivate Partnerships Develop Self and Others Drive Execution Influence Others Pursue Personal Excellence Understand the Business

This job description is not all inclusive. CareSource reserves the right to amend this job description at any time.

CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.

#LI-GB1 Brand=CareSource

The CareSource mission is known as our heartbeat. Just as we support our members to be the best version of themselves, our employees are driven by our mission to create a better world for members, stakeholders and providers. We are difference-makers who combine compassionate hearts with our unique business expertise to make every opportunity count. Each claim, each phone call, each consumer-centric decision is a chance to change the world for one member, and our employees look for ways to do that every day. The challenge is, there is no one right way to be the difference and we’re looking for people like you that will rewrite that definition every day. We do what it takes to form creative solutions that make our community and the world just a little better. Discover what it means to be #UniquelyCareSource.